梗阻性黄疸患者经皮经肝胆管引流术后应用异甘草酸镁治疗肝损害的疗效观察

摘要

Objective To evaluate the clinical efficacy and safety of magnesium isoglycyrrhizinate in the treatment of liver injury among pa-tients with obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD).Methods Sixty-two obstructive jaundice pa-tients with liver injury after PTCD were randomly divided into treatment group (n=32)and control group (n=30).All patients were given vitamin B6 ,vitamin C,and coenzyme complex by intravenous drip.At the same time,the treatment group was given magnesium isoglycyr-rhizinate (100 mg)after PTCD for 7 days,while the control group was given reduced glutathione (1200 mg)for 7 days.After treatment, the improvements in serum alanine transaminase (ALT),aspartate aminotransferase (AST),albumin (Alb),γ-glutamyl transpeptidase (GGT),alkaline phosphatase (ALP),total bilirubin (TBil),direct bilirubin (DBil),tumor necrosis factor-α(TNFα),and nuclear factor-kappa B (NF-κB)were evaluated.The adverse reactions associated with magnesium isoglycyrrhizinate were observed.Results After treatment,both groups showed significant decreases in serum TBil,DBil,ALT,AST,ALP,TNFα,and NF-κB (P<0.05 ),and the treatment group had significantly higher decreases in these indices (P<0.05).However,there were no significant improvements in Alb and GGT in either group after treatment,and the two indices showed no significant differences between the two groups (P>0.05).Conclu-sion Treated with magnesium isoglycyrrhizinate,obstructive jaundice patients with liver injury after PTCD can regain the liver function and recover from jaundice rapidly,and magnesium isoglycyrrhizinate has good efficacy and safety.%目的：评价梗阻性黄疸患者经皮经肝胆管引流术（PTCD）后使用异甘草酸镁治疗肝功能损伤的临床疗效及安全性。方法选择2009年6月-2011年4月收治的梗阻性黄疸的患者共62例，在PTCD术后配合应用维生素B6、维生素C、复合辅酶静脉点滴的基础上，随机分为治疗组32例，加用异甘草酸镁100 mg；对照组30例，加用还原型谷胱甘肽1200 mg。治疗1周后，比较ALT、AST、Alb、GGT、ALP、TBil、DBil及肿瘤坏死因子（TNF）α、NF-κB的变化情况；观察与药物相关的不良反应。结果治疗1周后，治疗组与对照组TBil、DBil、ALT、AST、ALP、TNFα、NF-κB较治疗前均明显下降（P＜0．05）；与对照组相比，治疗组TBil、DBil、ALT、AST、ALP、TNFα、NF-κB下降明显（P＜0.05）；但对Alb、GGT的改善两组治疗前后比较及组间比较差异无统计学意义（P＞0．05）。结论梗阻性黄疸患者PTCD术后经异甘草酸镁治疗肝功能损伤对尽快恢复肝功能，消退黄疸，有促进作用，有更好的疗效和安全性。