药物性肝损害S-腺苷蛋氨酸治疗的临床分析

目的评价不同剂量S-腺苷蛋氨酸治疗胆汁淤积型和混合型药物性肝损害的疗效和安全性。方法 66例胆汁淤积型和混合型药物性肝损害患者,分为对照组、治疗1组和治疗2组,每组22例,对照组给予常规基础保肝治疗外加用熊去氧胆酸和茵栀黄颗粒,治疗组除上述治疗外,同时加以S-腺苷蛋氨酸治疗。治疗1组应用S-腺苷蛋氨酸1g,1次/d,连续治疗4周;治疗2组以S-腺苷蛋氨酸2g,1次/d,连续治疗4周。监测各项肝功能指标。结果与对照组相比,治疗组总胆红素（TBil）、丙氨酸氨基转移酶（ALT）明显下降,差异有统计学意义（P〈0.05）。治疗2组疗效在降低TBil、ALT方面明显优于治疗1组,差异有统计学意义（P〈0.01）。结论胆汁淤积型和混合型药物性肝损害,给予S-腺苷蛋氨酸较常规保肝治疗效果明显,无不良反应,且大剂量疗效更为显著。

The effect of S-adenosyl-methionine treatment on drug-induced fiver injury

Objective To evaluate the therapeutic efficacy and safety of different dose S-adenosyl-L-methionine on drug-induced cholestasis liver injury and mixed liver injury.Methods a total of 66 patients suffered from drug-induced cholestasis liver injury and mixed liver injury were randomly divided into treatment group and control group.Furthermore,the treatment group was divided into 2 groups as treatment 1 group and treatment 2 group.The control group was treated with common therapy,while the treatment 1 group was treated with S-adenosyl-L-methionin up to 1 g/d as well as the treatment 2 group was treated with S-adenosyl-methionin up to 2 g/d.After 4 weeks of treatment,liver function was measured.Results The level of total bilirubin and alanine transaminase significantly decreased in the treatment group than the control group（P 0.05）.Moreover,no adverse reactions were observed.Total bilirubin and alanine transarninase significantly decreased in treatment 2 group compared to treatment 1 group（P 0.01）.Conclusion The therapeutic efficacy and safety of large dose S-adenosyl-L-methionin in treating drug-induced cholestasis liver injury and mixed liver injury is better compared to the common therapy.