【摘要】 目的评价熊去氧胆酸(ursodeoxycholic acid,UDCA,商品名优思弗)治疗慢性肝炎重度伴胆汁淤积的疗效及安全性。方法采用多中心、随机、对照的研究方法,将慢性肝炎重度伴胆汁淤积患者63例,随机分为治疗组与对照组;治疗组在原有内科治疗基础上加用UDCA治疗。结果治疗4周后,UDCA治疗组总有效率为81.8%,显著高于对照组的56.6%(P<0.05);总胆红素(TBil)、碱性磷酸酶(ALP)、胆汁酸(TBA)及谷氨酰转肽酶(GGT)分别下降为(53.0±20.6)μmol/L、(101.0±41.6)U/L、(120.0±22.8)μmol/L(、103.0±24.6)U/L,与对照组比较差异具有统计学意义(P<0.05或P<0.01)。治疗组UDCA不良反应轻微;随访3个月,总胆红素未出现反弹。结论UDCA联合内科综合治疗能更有效地改善慢性肝炎重度伴胆汁淤积患者的临床症状和肝功能指标,安全性良好。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of ursodeoxycholic acid(UDCA) in the treatment of severe chronic hepatitis with cholestasis.Methods Sixty-three severe chronic hepatitis patients with cholestasis were randomly divided into the treatment group and the control group.The treatment group was given UDCA besides basic therapy.The control group was only treated with conventional therapy.Results After 4 weeks’ treatment,the total effective rate in the treatment group was significantly higher than that in control group((81.8)% vs(56.6)%,P<(0.05)).The decreases on total bilirubin(TBil),bile acid,and γ-glutamyltransferase in the treatment group were much higher those those in the control group [TBil((53.0)±(20.6)) μmol/L,ALP((101.0)±(41.6)) U/L,TBA((120.0)±(22.8)) μmol/L,GGT((103.0)±(24.6)) U/L,P<(0.05) or P<(0.01)].Three month’s follow-up did not show reverse in the patients with persistent UDCA administration.The side effect of UDCA was mild in the whole process of treatment.Conclusion Compared with conventional therapy,combined therapy with UDCA is more effective in improving the symptom and liver function of patients with severe chronic hepatitis and cholestasis.And UDCA has no evident side effect in such patients.更多还原