腺苷蛋氨酸治疗肝内胆汁淤积性病毒性肝炎疗效观察

摘要

Objective To observe the efficacy and safety of ademetionine in the treatment of viral hepatitis with intrahepatic biliary stasis. Methods In this series, 110 patients with viral hepatitis associated intrahepatic biliary stasis were randomly divided into Groups A and B. Patients in Group A received ademetionine for four weeks. Patients in Group B received potassium magnesium aspartate for four weeks. Results In Group A, at the end of treatment, the effective rate for skin pruritus in patients with cholestatic hepatitis was 86.67% (13/15), and the effective rate for skin pruritus and anorexia were 88.24% (15/17) and 82.35% (14/17), respectively in patients with chronic hepatitis combining intrahepatic cholestasis, which were significantly higher than that in Group B (P<0.05). STB, SCB, TBA, ALT and AST were lower in Group A than Group B(P<0.05). The decrease of ALP and the increase of albumin after treatment were more significant in Group A than in Group B (P<0.05). Conclusion Ademetionine has better efficacy than potassium magnesium aspartate in the treament of patients with viral cholestatic hepatitis.%目的观察腺苷蛋氨酸治疗胆汁淤积性病毒性肝炎的疗效。方法 110例肝内胆汁淤积性病毒性肝炎患者随机分为A（治疗组）、B（对照组）两组，分别用腺苷蛋氨酸和门冬氨酸钾镁治疗，疗程均为4周。结果腺苷蛋氨酸对淤胆型肝炎皮肤瘙痒的有效率为86.67%（13/15），与对照组比差异有显著性（P＜0.05）；对慢性肝炎合并肝内胆汁淤积患者皮肤瘙痒、纳差的有效率分别为88.24%（15/17）、82.35%（14/17），与对照组比差异有显著意义（P＜0.05）。腺苷蛋氨酸治疗后，淤胆型肝炎和急、慢性肝炎合并肝内胆汁淤积患者血清总胆红素（STB）、血清结合胆红素（SCB）、总胆汁酸（TBA）、ALT、AST的降幅明显高于对照组（P＜0.05），治疗后ALP的下降有显著性意义（P＜0.05），STB、SCB、TBA的复常率显著高于对照组（P＜0.05）；淤胆型肝炎和慢性肝炎合并肝内胆汁淤积患者ALT的复常率较对照组差异有显著意义（P＜0.05）；慢性肝炎合并肝内胆汁淤积患者血清白蛋白在治疗后的增高也有显著性意义（P＜0.05）。结论腺苷蛋氨酸治疗胆汁淤积性病毒性肝炎疗效较好,优于门冬氨酸钾镁，没有明显不良反应。