【摘要】 目的 比较异甘草酸镁注射液与还原型谷胱甘肽治疗老年脓毒症相关肝损害患者的临床疗效。方法 回顾性分析2019年1月—2021年12月复旦大学附属华山医院静安分院收治的117例老年脓毒症并发肝损害患者相关资料。观察组(n=58)在脓毒症常规治疗的基础上，联合异甘草酸镁注射液；对照组(n=59)在脓毒症常规治疗的基础上联合注射用还原型谷胱甘肽，疗程21 d。比较2组治疗前后的脓毒症指标、肝功能指标和心血管系统指标，分析患者的预后。结果 与治疗前比较，治疗21 d后观察组白细胞(WBC)、C反应蛋白(CRP)、白细胞介素(IL-6)和D-二聚体(DD)水平降低(P<0.01);降钙素(PCT)、血乳酸(BLA)和N末端B型钠尿肽原(NT-proBNP)水平降低(P<0.001)。2组WBC、CRP、IL-6、PCT、BLA、DD及NT-proBNP治疗前后的差值差异有统计学意义(P<0.01)。与治疗前比较，治疗21 d后2组总胆红素(TBIL)和谷丙转氨酶(GPT)水平降低(P<0.01)。2组TBIL和GPT治疗前后的差值差异无统计学意义(P>0.05)。对照组死亡率高于观察组(23.73%vs 8.62%,P=0.027)。结论 异甘草酸镁注射液能够一定程度上降低老年脓毒症相关肝损害患者的死亡率，减轻炎症反应，缓解心力衰竭，且其保肝作用与还原型谷胱甘肽无异。更多还原

【Abstract】 Objective To compare the clinical efficacy between magnesium isoglycyrrhizinate injection and reduced glutathione in the treatment of elderly patients with sepsis-related liver damage. Methods The data of 117 elderly patients with sepsis complicated with liver damage admitted to Jing’an Branch of Huashan Hospital Affiliated to Fudan University from January 2019 to December 2021 were retrospectively analyzed. On the basis of routine treatment of sepsis, the observation group(n=58) was treated with magnesium isoglycyrrhizate injection, while the control group(n=59) was treated with reduced glutathione for injection. The course of treatment was 21 days. The sepsis indexes, liver function indexes and cardiovascular system indexes were compared between the two groups before and after treatment, and the prognosis of the patients was analyzed. Results Compared with before treatment, the levels of white blood cells(WBC), C-reactive protein(CRP), interleukin(IL-6) and D-dimer(DD) of the observation group decreased after 21 days of treatment(P<0.01); the levels of procalcitonin(PCT), blood lactate(BLA) and N-terminal pro-B-type natriuretic peptide(NT-proBNP) decreased(P<0.001). The differences of WBC, CRP, IL-6, PCT, BLA, DD and NT-proBNP before and after treatment were statistically significant between the two groups(P<0.01). Compared with before treatment, the levels of total bilirubin(TBIL) and alanine aminotransferase(GPT) in the two groups decreased after 21 days of treatment(P<0.01). The difference of TBIL and GPT before and after treatment was no statistical significance between the two groups(P>0.05). The mortality of the control group was higher than that of the observation group(23.73% vs 8.62%, P=0.027). Conclusion Magnesium isoglycyrrhizate injection can reduce the mortality of elderly patients with sepsis-related liver damage to a certain extent, reduce the inflammatory reaction and relieve heart failure, and its liver protection effect is no different from that of reduced glutathione.更多还原