S-腺苷蛋氨酸治疗急性胆汁淤积性肝炎的疗效

目的评估S-腺苷蛋氨酸治疗急性胆汁淤积性肝炎的效果及不良反应。方法选择76例急性胆汁淤积性肝炎患者,分为治疗组（47例）和对照组（29例）进行临床对比观察。对照组给予甘草酸二铵和茵栀黄治疗,静脉注射4周;治疗组在上述治疗基础上加用S-腺苷蛋氨酸,1000mg/d,静脉注射4周。分别在不同时间点（第2、4、6周）针对临床症状、生化指标（TBil、ALT、AST、ALP、GGT）及不良反应进行观察。结果与治疗前TBil水平比较,治疗第2、4、6周时的TBil降幅率治疗组分别为46%、77%、92%,对照组分别为37%、60%、90%,差异均有统计学意义（P〈0.05）。两组临床症状均有改善,皮肤瘙痒改善率治疗组为70.0%,对照组为45.0%,差异有统计学意义（P〈0.05）。结论 S-腺苷蛋氨酸退黄疸速度快,尤以前4周下降速度快,同时对改善胆汁淤积性肝炎患者的皮肤瘙痒有显著疗效,且无明显不良反应。

Effect of S-adenosyl methionine on acute cholestasis hepatitis patients

Objective To evaluate the effect and adverse events of S-adenosyl methionine on acute cholestasis hepatitis patients.Methods Total of 76 patients with acute cholestasis hepatitis were randomly divided into two groups：the control group（29 cases） were intravenously injected with diammonium glycyrrhizinate and Yinzhihuang,while the S-adenosyl methionine therapeutic group（47 cases） were treated with S-adenosyl methionine（1000 mg/d） besides the above medicines.After treatment for 2,4 and 6 weeks,the manifestations changes were estimated and the clinical symptoms,serum parameters of liver function（TBil,ALT,AST,ALP,GGT） and adverse events were detected for both groups.Results After treatment for 2,4 and 6 weeks,descents of serum TBil in the therapeutic group were 46%,77%,92%,respectively,which were 37%,60% and 90% in the control group.Clinical symptoms were improved in both groups.The improvement rate of skin pruritus in therapeutic group（70.0%） was signif icantly higher than that in control group（45.0%）.Conclusions S-adenosyl methionine can decrease jaundice rapidly,especially in 4 weeks,also it may improve skin pruritus signif icantly and no serious adverse events were reported.