柳氮磺吡啶联合熊脱氧胆酸治疗原发性硬化性胆管炎的有效性探讨

摘要

[目的]探讨柳氮磺吡啶（SASP）联合熊脱氧胆酸（UDCA）治疗原发性硬化性胆管炎的有效性。[方法]将30例原发性硬化性胆管炎患者分别纳入联合组、UDCA组、SASP组，每组10例；联合组口服UDCA联合SASP治疗，UDCA组单独口服UDCA治疗，SASP组单独口服SASP治疗。评价指标为治疗12周后，血清碱性磷酸酶、谷酰转肽酶、血清总胆红素的降低程度，以及1年后胆道镜下病变进展情况。[结果]30例中有29例完成全部治疗，联合组与UDCA组患者治疗后血清碱性磷酸酶、谷酰转肽酶、总胆红素较治疗前均明显下降，差异均有统计学意义（P＜0.05～0.01）；SASP组治疗前后血清碱性磷酸酶、谷酰转肽酶差异具有统计学意义（P＜0.01），而总胆红素治疗前后差异无统计学意义（ P＞0.05）。联合组血清各项指标均较 UDCA 组、SASP组降低更明显（ P＜0.05～0.01）。1年后各组患者病变进展情况相比差异无统计学意义（P＞0.05）。[结论]单独或联合应用SASP与UDCA治疗原发性硬化性胆管炎有一定的短期临床效果，且联合应用效果可能更好。%Objective]To evaluate the efficacy and safety of combination treatment of salazosulfapyri-dine(SASP)and ursodeoxycholic acid(UDCA)in primary sclerosing cholangitis(PSC).[Methods]Thirty pa-tients with PSC were included and randomly divided into three groups :combination group(n=10) ,patients treated with SASP and UDCA combinatively ;UDCA group(n= 10) ,patients treated with UDCA ;SASP group(n=10) ,patients treated with SASP.ALP ,GGT ,TBiL were used to evaluated the safety of treat-ment before the treatment and 12 weeks after the beginning of treatment.Effect of therapy on liver histolo-gy was evaluated by choledochoscope.[Results]There were 29 patients finished the whole treatment.In combination group ,the ALP ,GGT and TBiL decrease significantly than those in UDCA group(P<0.05).In SASP group ,only ALP and GGT were decreased significantly(P<0.01) ,and the difference of TBil be-fore and after treatment was not signifcant(P>0.05).The effect of combination treatment seemed to be more useful(P<0.05).The choledochoscope examination showed no differences in liver histology in the three groups(P>0.05).[Conclusions]The combination or single use of SASP and UDCA contribute to treatment on PSC in short-term.Combination treatment prection higher effection.