Clinical efficacy of glucocorticoid therapy in treatment of drug-induced cholestatic liver disease
-
摘要:
目的观察在常规治疗基础上加用糖皮质激素在胆汁淤积型药物性肝病患者中的疗效。方法收集内蒙古民族大学附属医院2010年1月-2014年12月收治的胆汁淤积型药物性肝病患者115例,按照是否应用激素治疗分为激素治疗组和非激素治疗组。激素治疗组在常规治疗基础上给予甲泼尼龙琥珀酸钠120 mg,1次/d,静脉滴注,以第3天TBil下降10%或第7天下降30%以上作为激素有反应的指标。然后根据TBil的水平改为口服泼尼松片10 mg,3次/d,1周后改为2次/d,疗程不超过3周。符合正态分布的计量资料组间比较采用t检验,不符合正态分布的计量资料组间比较采用秩和检验。结果激素治疗组GGT、ALT、TBil在应用激素治疗第3、7、14天较治疗前水平均明显下降,差异均有统计学意义(GGT的t值分别为3.64、13.08、16.22;ALT的t值分别为2.39、4.73、8.36;TBil的t值分别为3.46、7.41、13.17,P值均<0.05)。在治疗前、治疗第3、7天时激素治疗组ast与alt水平低于非激素治疗组,但差异无统计学意义(p值均>0.05)。治疗第14天时激素治疗组GGT、...
Abstract:Objective To analyze the clinical efficacy of glucocorticoid therapy in addition to conventional treatment for patients with drug-induced cholestatic liver disease. Methods A total of 115 patients with drug- induced cholestatic liver disease who were admitted to Affiliated Hospital of Inner Mongolia University for the Nationalities from January 2010 to December 2014 were collected and divided into glucocorticoid treatment group and non- glucocorticoid treatment group. The glucocorticoid treatment group was given methylprednisolone sodium succinate 120 mg once daily by intravenous injection in addition to conventional treatment. The indicator for glucocorticoid response was defined as 10% decrease of total bilirubin( TBil) on the third day or 30% decrease on the seventh day. Then the patients were orally given prednisone tablets 10 mg three times daily based on the level of TBil,and the administration of prednisone tablets was adjusted to twice daily a week later. The course of treatment was less than three weeks. Comparison of continuous data in normal distribution between the two groups was made by t test,and comparison of continuous data not in normal distribution between the two groups was made by rank sum test. Results The levels of gamma- glutamyl transpeptidase( GGT),alanine aminotransferase( ALT),and TBil in the glucocorticoid treatment group decreased significantly on days 3,7,and 14 of treatment compared with those before treatment( tGGT= 3. 64,13. 08,16. 22; tALT= 2. 39,4. 73,8. 36; tTBil= 3. 46,7. 41,13. 17; all P < 0. 05). Compared with the non- glucocorticoid treatment group,the glucocorticoid treatment group had significantly lower AST and ALT levels before treatment and on days 3 and 7 of treatment( all P > 0. 05). The GGT,AST,and TBil levels in the glucocorticoid treatment group were significantly lower than those in the non- glucocorticoid treatment group on day 14 of treatment( t = 7. 074,2. 929,2. 018; all P < 0. 05). The average decreasing speed of bilirubin in the glucocorticoid treatment group was12. 21% ± 2. 91% per day,significantly faster than 6. 27% ± 0. 92% per day in the non- glucocorticoid treatment group( t = 15. 11,P <0. 001). Conclusion Glucocorticoid therapy in addition to conventional treatment for patients with drug- induced cholestatic liver disease is superior to conventional treatment alone in lowering TBil,GGT,and ALT levels.
-
Key words:
- hepatitis,chronic,drug-induced /
- cholestasis /
- glucocorticoids
计量
- 文章访问数: 2693
- HTML全文浏览量: 16
- PDF下载量: 548
- 被引次数: 0