N-乙酰半胱氨酸治疗慢性乙型肝炎重度患者的疗效

目的 观察N-乙酰半胱氨酸(NAC)和还原型谷胱甘肽(GSH)治疗慢性乙型肝炎重度患者的临床疗效和安全性.方法 75例慢性乙型肝炎重度患者随机分为NAC组(50例)和GSH组(25例),在综合治疗的基础上,分别静脉滴注NAC注射液8g或GSH 1.2g,1次/d,用药28 d.比较治疗前后两组患者的临床症状、血清总胆红素、凝血酶原活动度等,并以血清总胆红素和凝血酶原活动度两个指标的改善来评价综合疗效.观察两组患者用药后的不良反应情况.结果 NAC与GSH均有保肝、降胆红素的作用,总有效率分别为84%和72%,并且NAC降低胆红素的速度更快(P<0.05),在治疗的14d和21 d,总胆红素下降率分别为20.89%±12.36%和31.76%±17.41%.NAC组不良反应主要表现为恶心、呕吐、皮疹等,发生率为13%,未发生严重不良反应.结论 NAC与GSH均能降低患者血清总胆红素,提升凝血酶原活动度.NAC在降低胆红素速度上优于GSH,用药过程中患者耐受性好,无严重的不良反应.

A clinical study of N-acetylcysteine treatment in chronic hepatitis B patients

OBJECTIVE: To evaluate the efficacy and safety of N-acetylcysteine (NAC) and glutathione (GSH) in treating chronic hepatitis B patients. METHODS: Seventy-five patients with chronic hepatitis B were treated daily with an injection containing the same basic therapeutic drugs and randomly divided into a NAC group (50 patients) and a GSH group (25 patients). A daily dose of 8 grams of NAC and 1.2 grams of GSH was added to the injections of the two groups respectively. The trial lasted 28 days. Hepatic function and other biochemistry parameters (TBil, PTA, ALB et al) were tested on experimental day 0 and on days 7, 14, 21 and 28. The evaluation on the total effective rates of the NAC and GSH groups was based on the decreases of serum TBil and the increases of PTA. RESULTS: Both NAC and GSH have therapeutic effects. The total effective rate was 84% in the NAC group and 72% in the GSH group. The rate of side effects was 13% in the NAC group. CONCLUSION: NAC and GSH can decrease the level of serum TBil and increase PTA, but NAC was more effective in decreasing TBil than GSH. Serious adverse effects of NAC were not observed during the period of our treatment. [Chinese FullText URL http://zhgz.chinajournal.net.cn].