糖皮质激素治疗婴儿胆汁淤积性肝病的临床观察
发布时间：2018-08-24 11:11
【摘要】：目的：在常规治疗的基础上加用糖皮质激素(glucocorticoid, GCS)对胆汁淤积性肝病患儿进行治疗观察,比较常规疗法和糖皮质激素对胆汁淤积性肝病的临床治疗效果。方法：选择在广西医科大学第一附属医院儿科住院诊断为胆汁淤积性肝病患儿56例,采用简单数字表法随机分为常规用药组(对照组,28例)和GCS治疗组(实验组,28例),对照组予以静脉滴注丁二磺酸腺苷蛋氨酸和复方甘草酸苷,实验组在常规治疗的基础上予以静脉滴注氢化可的松琥珀酸钠,1周后改为醋酸泼尼松片口服,2周内减停,总疗程3周,此后两组继续口服复方甘草酸苷及熊去氧胆酸,定期门诊随访,比较两组治疗前后肝功能指标的改善程度。结果：1.与治疗前比较,两组肝功能经治疗后均有好转,对照组治疗1周后TBIL、DBIL (P0.01) 及 TBA, ALT (P0.05)变化有显著性差异,治疗3周后TBIL、DBIL(P0.01)变化有显著性差异,治疗2月后TBIL、 DBIL、IBIL (P0.01)变化有显著性差异：实验组治疗1周后TBIL、DBIL (P0.01)及IBIL、PA (P0.05)变化有显著性差异,治疗3周后TBIL、 DBIL、IBIL、ALB、PA (P0.01)变化有显著性差异,治疗2月后TBIL、 DBIL、IBIL、ALB (P0.01)及ALP、PA、CHE (P0.05)的变化有显著性差异,其他指标无显著性差异(P0.05)。2.治疗1周、3周后PA上升的幅度,实验组较对照组明显,差异有显著性；治疗2月后肝功能各指标变化幅度均无显著性差异(P值均0.05)。结论：1.糖皮质激素治疗婴儿胆汁淤积性肝病的降胆红素效果与常规治疗差别不大,对血清γ-GT无显著作用,亦不能有效促进TBA排泌；2.糖皮质激素能促进前白蛋白的合成,有助于肝细胞功能的恢复；3.临床治疗婴儿胆汁淤积性肝病需结合患儿病情,合理使用激素。
[Abstract]:Objective: to observe the effect of routine therapy and glucocorticoid (glucocorticoid, GCS) on cholestatic liver disease in children. Methods: 56 pediatric patients with cholestatic liver disease were selected from the first affiliated Hospital of Guangxi Medical University. A simple digital table method was used to divide the two groups randomly into two groups: control group (n = 28) and GCS group (n = 28). The control group was given intravenous drip of adenosylmethionine butyrate and compound glycyrrhizin. The experimental group was given hydrocortisone sodium succinate intravenously for 1 week on the basis of routine treatment. The treatment group was treated with prednisone acetate tablets for 3 weeks. After that, the two groups continued to take compound glycyrrhizin and ursodeoxycholic acid. To compare the improvement of liver function between the two groups before and after treatment. The result is 1: 1. The changes of TBIL,DBIL (P0.01) and TBA, ALT (P0.05) in the control group were significantly different after 1 week of treatment, and there were significant differences in the changes of TBIL,DBIL (P0.01) after 3 weeks of treatment. There were significant differences in TBIL, DBIL,IBIL (P0.01) and IBIL,PA (P0.01) after 1 week of treatment in experimental group, significant difference in TBIL, DBIL,IBIL,ALB,PA (P0.01) after 3 weeks of treatment, and significant difference in TBIL, DBIL,IBIL,ALB (P0.01) and ALP,PA,CHE (P0.05) after 2 months of treatment. There was no significant difference in other indexes (P0.05). The increase of PA in the experimental group was significantly higher than that in the control group (P < 0. 05), and there was no significant difference between the two months after treatment (P < 0. 05). Conclusion 1. The effect of glucocorticoid on reducing bilirubin in infantile cholestatic liver disease was not different from that in routine treatment, but had no significant effect on serum 纬 -GT, nor could it promote TBA excretion effectively. Glucocorticoid can promote the synthesis of prealbumin and contribute to the recovery of hepatocyte function. Clinical treatment of infantile cholestatic liver disease should be combined with the condition of children, rational use of hormones.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R725.7
本文编号：2200640
[Abstract]:Objective: to observe the effect of routine therapy and glucocorticoid (glucocorticoid, GCS) on cholestatic liver disease in children. Methods: 56 pediatric patients with cholestatic liver disease were selected from the first affiliated Hospital of Guangxi Medical University. A simple digital table method was used to divide the two groups randomly into two groups: control group (n = 28) and GCS group (n = 28). The control group was given intravenous drip of adenosylmethionine butyrate and compound glycyrrhizin. The experimental group was given hydrocortisone sodium succinate intravenously for 1 week on the basis of routine treatment. The treatment group was treated with prednisone acetate tablets for 3 weeks. After that, the two groups continued to take compound glycyrrhizin and ursodeoxycholic acid. To compare the improvement of liver function between the two groups before and after treatment. The result is 1: 1. The changes of TBIL,DBIL (P0.01) and TBA, ALT (P0.05) in the control group were significantly different after 1 week of treatment, and there were significant differences in the changes of TBIL,DBIL (P0.01) after 3 weeks of treatment. There were significant differences in TBIL, DBIL,IBIL (P0.01) and IBIL,PA (P0.01) after 1 week of treatment in experimental group, significant difference in TBIL, DBIL,IBIL,ALB,PA (P0.01) after 3 weeks of treatment, and significant difference in TBIL, DBIL,IBIL,ALB (P0.01) and ALP,PA,CHE (P0.05) after 2 months of treatment. There was no significant difference in other indexes (P0.05). The increase of PA in the experimental group was significantly higher than that in the control group (P < 0. 05), and there was no significant difference between the two months after treatment (P < 0. 05). Conclusion 1. The effect of glucocorticoid on reducing bilirubin in infantile cholestatic liver disease was not different from that in routine treatment, but had no significant effect on serum 纬 -GT, nor could it promote TBA excretion effectively. Glucocorticoid can promote the synthesis of prealbumin and contribute to the recovery of hepatocyte function. Clinical treatment of infantile cholestatic liver disease should be combined with the condition of children, rational use of hormones.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R725.7
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