天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (7): 723-726.doi: 10.11958/20210367

• 临床研究 • 上一篇    下一篇

人工肝支持系统与糖皮质激素治疗重度急性药物性肝损伤的疗效

刘师伟，梁静，唐飞，刘华，刘磊，刘芳，王凤梅   

  1. 1天津医科大学研究生院（邮编300070）；2天津市津南医院内科；3天津市第三中心医院肝内科
  • 收稿日期:2021-02-07 修回日期:2021-02-19 出版日期:2021-07-15 发布日期:2021-07-12
  • 作者简介:刘师伟（1982），男，硕士，主治医师，主要从事常见肝病临床研究。E-mail：liushiwei119@163.com
  • 基金资助:
    天津市慢性病防治科技重大专项（17ZXMFSY00170）；国家科技重大专项课题（2018ZX10732202）

Comparative analysis on clinical efficacy of artificial liver support system and glucocorticoid therapy for severe acute drug-induced liver injury

LIU Shi-wei, LIANG Jing, TANG Fei, LIU Hua, LIU Lei, LIU Fang, WANG Feng-mei   

  1. 1 Graduate School, Tianjin Medical University, Tianjin 300070, China; 2 Department of Internal Medicine, Tianjin Jinnan Hospital; 3 Department of Hepatology, Tianjin Third Central Hospital
  • Received:2021-02-07 Revised:2021-02-19 Published:2021-07-15 Online:2021-07-12

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摘要： 目的　对比分析人工肝支持系统（ALSS）与糖皮质激素治疗重度急性药物性肝损伤的临床疗效及安全性。方法　回顾性分析120例重度急性药物性肝损伤患者的临床资料，按照治疗方式不同分为ALSS组和激素组，每组60例。比较2组患者治疗前、后肝功能改善及不良反应发生等情况。结果　2组患者治疗后临床症状均有明显改善，与治疗前比较，治疗后2组患者的血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆汁酸（TBA）、总胆红素（TBIL）均显著降低，凝血酶原活动度（PTA）显著升高（P＜0.05），且ALSS组较激素组疗效更显著（P＜0.05）。ALSS组总有效率明显高于激素组（χ2=5.175，P＜0.05），2组均未发生严重不良反应，安全性较高。结论　ALSS治疗及激素治疗均可有效改善重度急性药物性肝损伤的临床症状及肝功能，ALSS在显效时间及有效率方面优于糖皮质激素且安全性较高。

关键词: 肝, 人工, 糖皮质激素类, 化学性与药物性肝损伤, 重度急性药物性肝损伤

Abstract: Objective　To compare and analyze the clinical efficacy and safety of artificial liver support system (ALSS) and glucocorticoid in the treatment of severe acute drug-induced liver injury. Methods　The clinical data of 120 patients with severe acute drug-induced liver injury were retrospectively analyzed. These patients were divided into ALSS group and glucocorticoid group according to different treatment methods, with 60 cases in each group. The liver function and adverse reactions were compared before and after treatment between the two groups. Results　The clinical symptoms were significantly improved after treatment in the two groups of patients. Compared with before treatment, the serum alanine transferase (ALT), aspartic acid transferase (AST), total bile acid (TBA) and total bilirubin (TBIL) were significantly reduced after treatment in the two groups (P＜0.05), and the prothrombin activity (PTA) was significantly increased (P＜0.05). The clinical effect of the ALSS group was more significant than that of the glucocorticoid group (P＜0.05). The total effective rate of the ALSS group was significantly higher than that of the glucocorticoid group (χ2=5.175, P＜0.05). There were no serious adverse reactions in the two groups, and the safety of these two methods were good. Conclusion　Both ALSS treatment and glucocorticoid treatment can effectively improve the clinical symptoms and liver function of severe acute liver damage. ALSS treatment is superior to glucocorticoids in effective time and efficiency in the treatment of patients with severe acute drug-induced liver damage, and has higher safety.

Key words: liver, artificial, glucocorticoids, chemical and drug induced liver injury, severe acute drug-induced liver injury