CAJ | 학술논문

目的观察腺苷蛋氨酸治疗儿童急性药物性肝病淤胆型和混合型的疗效及安全性.方法治疗组和对照组均予茵栀黄冲剂口服,复方甘草酸苷注射液静脉滴注治疗,治疗组加用腺苷蛋氨酸(思美泰)250～1000 mg静脉滴注治疗28 d.观察患儿瘙痒、生化指标及不良反应.统计学处理:组间比较,计数资料采用X~2检验,计量资料采用t检验.结果 (1)治疗组和对照组在治疗前分别为17例、16例患儿有明显的瘙痒感,治疗2周后治疗组和对照组分别有14例及3例明显减轻(X~2=4.52,P＜0.05).(2)治疗4周后两组的AST比较P=0.0014;黄疸的消退在2周、4周及复常率比较P值分别为0.045、0.007及P＜0.05;TBA的下降在治疗后的2周、4周比较P值分别为0.0014和P=0.0006;γGT在治疗后4周比较P=0.0003.结论腺苷蛋氨酸在儿童的静脉注射中比较安全.且能显著减轻患儿的瘙痒;加快患儿各种生化指标的复常,促进肝脏的恢复.因此腺苷蛋氨酸(思美泰)治疗儿童肝内胆汁淤积值得进一步推广应用.
목적 관찰선감단안산치료인동급성약물성간병어담형화혼합형적료효급안전성.방법 치료조화대조조균여인치황충제구복,복방감초산감주사액정맥적주치료,치료조가용선감단안산(사미태)250～1000 mg정맥적주치료28 d.관찰환인소양、생화지표급불량반응.통계학처리:조간비교,계수자료채용X~2검험,계량자료채용t검험.결과 (1)치료조화대조조재치료전분별위17례、16례환인유명현적소양감,치료2주후치료조화대조조분별유14례급3례명현감경(X~2=4.52,P＜0.05).(2)치료4주후량조적AST비교P=0.0014;황달적소퇴재2주、4주급복상솔비교P치분별위0.045、0.007급P＜0.05;TBA적하강재치료후적2주、4주비교P치분별위0.0014화P=0.0006;γGT재치료후4주비교P=0.0003.결론 선감단안산재인동적정맥주사중비교안전.차능현저감경환인적소양;가쾌환인각충생화지표적복상,촉진간장적회복.인차선감단안산(사미태)치료인동간내담즙어적치득진일보추엄응용.
Objective To investigate the efficacy and safety of ademetionine for treatment of cholestatic or mixed-type drug-induced liver disease (DILD) in children.Methods The children with DILD were divided into the treated group and control group.Yinzhihuang Granule was orally administered and Compound Glycyrrhizin Injection intravenously given in patients of both groups.Those patients in the treated group were additionally treated with intravenous infusion of 250-1000 mg ademetionine for 28 d.The incidence of pruritus and adverse effects as well as biochemical parameters in all the patients and compared between the 2 groups.For statistical analysis,X~2 test was used for between-group comparison and t test for processing the data.Results 1) Before treatment,severe pruritus was found in 17 and 16 children in the treated and control group,respectively.Two weeks after the treatment,the symptom was significantly relieved in 14 and 3 patients in the treated and control group,respectively (X~2= 4.52,P＜0.05).2) As for comparisons between the 2 groups,a P value of 0.0014 for AST level was found 4 weeks,0.045 and 0.007 for disappearance and recovery rate of jaundice,0.0014 and 0.0006 for decrease in TBA level and 0.0003 for γGT level 2 and 4 weeks after the treatment.Conclusion Intravenous administration of ademetionine is safe in children with DILD and it can effectively alleviate pruritus,promote the recovery of various biochemical parameters and fasten liver functional recovery in these children.Therefore,ademetionine can be widely used for treatment of intrahepatic cholestasis in children.