异甘草酸镁治疗抗结核药物性肝损伤疗效

目的 探讨异甘草酸镁(MgIG)治疗对抗结核药物引起肝损伤患者的疗效及细胞因子(IFN-γ, IL-10, TNF-α)的影响。方法 选取2016年2月至2019年12月昆明医科大学第六附属医院感染科就诊的符合抗结核药物性肝损伤诊断标准的轻度肝细胞损伤型患者,随机分为观察组使用MgIG治疗(n=25)和对照组使用多烯磷脂酰胆碱治疗(n=25)。比较两组患者治疗前后肝功能(ALT, AST, TBIL)和细胞因子水平(IFN-γ, IL-10, TNF-α)变化。结果 观察组患者治疗总有效率显著高于对照组患者(100% vs 76.0%, P<0.01)。两组患者IFN-γ、IL-10、TNF-α均较治疗前降低(P均<0.05);观察组IFN-γ, IL-10, TNF-α均低于对照组(P均<0.05)。Pearson相关分析显示,两组治疗前、治疗后的所有细胞因子水平与ALT呈正相关关系。结论 在轻度的抗结核药物性肝损伤中,MgIG快速改善肝功能可能与其降低炎症细胞因子相关。

Efficacy of magnesium isoglycyrrhizinate in anti-tuberculosis drug-induced liver injury

Objective To explore the efficacy of magnesium isoglycyrrhizinate(MgIG) in the treatment of anti-tuberculosis drug-induced liver injury (AT-DILI) and influence on cytokines (IFN-γ, IL-10, TNF-α).Methods The study enrolled 50 patients with mild hepatocellular injury who admitted to Infection Department, the Sixth Affiliated Hospital of Kunming Medical University from February 2016 to December 2019, and the patients met the criteria of AT-DILI. Patients were randomly grouped, 25 patients in observation group treated with MgIG, 25 patients in control group with polyene phosphatidylcholine(PPC). The key observation was liver function (ALT, AST, TBIL) and cytokine levels (IFN-γ, IL-10, TNF-α).Results The total effective rates were significantly higher in observation group than in control group (100% vs 76.0%, P<0.01). Compared with before treatment, IFN-γ, IL-10, and TNF-α in both groups were lower after treatment (all P<0.05), and the indexes were significantly decreased in observation group (all P<0.05). Pearson correlation analysis showed the cytokine levels were positively correlated with ALT in both groups at different time points.Conclusion MgIG can quickly improve liver function in mild AT-DILI, which may relate to the reduction of inflammatory cytokines.