糖皮質(zhì)激素治療嬰兒膽汁淤積性肝病的臨床觀察
發(fā)布時間：2018-08-24 11:11
【摘要】：目的：在常規(guī)治療的基礎(chǔ)上加用糖皮質(zhì)激素(glucocorticoid, GCS)對膽汁淤積性肝病患兒進(jìn)行治療觀察,比較常規(guī)療法和糖皮質(zhì)激素對膽汁淤積性肝病的臨床治療效果。方法：選擇在廣西醫(yī)科大學(xué)第一附屬醫(yī)院兒科住院診斷為膽汁淤積性肝病患兒56例,采用簡單數(shù)字表法隨機(jī)分為常規(guī)用藥組(對照組,28例)和GCS治療組(實(shí)驗(yàn)組,28例),對照組予以靜脈滴注丁二磺酸腺苷蛋氨酸和復(fù)方甘草酸苷,實(shí)驗(yàn)組在常規(guī)治療的基礎(chǔ)上予以靜脈滴注氫化可的松琥珀酸鈉,1周后改為醋酸潑尼松片口服,2周內(nèi)減停,總療程3周,此后兩組繼續(xù)口服復(fù)方甘草酸苷及熊去氧膽酸,定期門診隨訪,比較兩組治療前后肝功能指標(biāo)的改善程度。結(jié)果：1.與治療前比較,兩組肝功能經(jīng)治療后均有好轉(zhuǎn),對照組治療1周后TBIL、DBIL (P0.01) 及 TBA, ALT (P0.05)變化有顯著性差異,治療3周后TBIL、DBIL(P0.01)變化有顯著性差異,治療2月后TBIL、 DBIL、IBIL (P0.01)變化有顯著性差異：實(shí)驗(yàn)組治療1周后TBIL、DBIL (P0.01)及IBIL、PA (P0.05)變化有顯著性差異,治療3周后TBIL、 DBIL、IBIL、ALB、PA (P0.01)變化有顯著性差異,治療2月后TBIL、 DBIL、IBIL、ALB (P0.01)及ALP、PA、CHE (P0.05)的變化有顯著性差異,其他指標(biāo)無顯著性差異(P0.05)。2.治療1周、3周后PA上升的幅度,實(shí)驗(yàn)組較對照組明顯,差異有顯著性；治療2月后肝功能各指標(biāo)變化幅度均無顯著性差異(P值均0.05)。結(jié)論：1.糖皮質(zhì)激素治療嬰兒膽汁淤積性肝病的降膽紅素效果與常規(guī)治療差別不大,對血清γ-GT無顯著作用,亦不能有效促進(jìn)TBA排泌；2.糖皮質(zhì)激素能促進(jìn)前白蛋白的合成,有助于肝細(xì)胞功能的恢復(fù)；3.臨床治療嬰兒膽汁淤積性肝病需結(jié)合患兒病情,合理使用激素。
[Abstract]:Objective: to observe the effect of routine therapy and glucocorticoid (glucocorticoid, GCS) on cholestatic liver disease in children. Methods: 56 pediatric patients with cholestatic liver disease were selected from the first affiliated Hospital of Guangxi Medical University. A simple digital table method was used to divide the two groups randomly into two groups: control group (n = 28) and GCS group (n = 28). The control group was given intravenous drip of adenosylmethionine butyrate and compound glycyrrhizin. The experimental group was given hydrocortisone sodium succinate intravenously for 1 week on the basis of routine treatment. The treatment group was treated with prednisone acetate tablets for 3 weeks. After that, the two groups continued to take compound glycyrrhizin and ursodeoxycholic acid. To compare the improvement of liver function between the two groups before and after treatment. The result is 1: 1. The changes of TBIL,DBIL (P0.01) and TBA, ALT (P0.05) in the control group were significantly different after 1 week of treatment, and there were significant differences in the changes of TBIL,DBIL (P0.01) after 3 weeks of treatment. There were significant differences in TBIL, DBIL,IBIL (P0.01) and IBIL,PA (P0.01) after 1 week of treatment in experimental group, significant difference in TBIL, DBIL,IBIL,ALB,PA (P0.01) after 3 weeks of treatment, and significant difference in TBIL, DBIL,IBIL,ALB (P0.01) and ALP,PA,CHE (P0.05) after 2 months of treatment. There was no significant difference in other indexes (P0.05). The increase of PA in the experimental group was significantly higher than that in the control group (P < 0. 05), and there was no significant difference between the two months after treatment (P < 0. 05). Conclusion 1. The effect of glucocorticoid on reducing bilirubin in infantile cholestatic liver disease was not different from that in routine treatment, but had no significant effect on serum 緯 -GT, nor could it promote TBA excretion effectively. Glucocorticoid can promote the synthesis of prealbumin and contribute to the recovery of hepatocyte function. Clinical treatment of infantile cholestatic liver disease should be combined with the condition of children, rational use of hormones.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R725.7
本文編號：2200640
[Abstract]:Objective: to observe the effect of routine therapy and glucocorticoid (glucocorticoid, GCS) on cholestatic liver disease in children. Methods: 56 pediatric patients with cholestatic liver disease were selected from the first affiliated Hospital of Guangxi Medical University. A simple digital table method was used to divide the two groups randomly into two groups: control group (n = 28) and GCS group (n = 28). The control group was given intravenous drip of adenosylmethionine butyrate and compound glycyrrhizin. The experimental group was given hydrocortisone sodium succinate intravenously for 1 week on the basis of routine treatment. The treatment group was treated with prednisone acetate tablets for 3 weeks. After that, the two groups continued to take compound glycyrrhizin and ursodeoxycholic acid. To compare the improvement of liver function between the two groups before and after treatment. The result is 1: 1. The changes of TBIL,DBIL (P0.01) and TBA, ALT (P0.05) in the control group were significantly different after 1 week of treatment, and there were significant differences in the changes of TBIL,DBIL (P0.01) after 3 weeks of treatment. There were significant differences in TBIL, DBIL,IBIL (P0.01) and IBIL,PA (P0.01) after 1 week of treatment in experimental group, significant difference in TBIL, DBIL,IBIL,ALB,PA (P0.01) after 3 weeks of treatment, and significant difference in TBIL, DBIL,IBIL,ALB (P0.01) and ALP,PA,CHE (P0.05) after 2 months of treatment. There was no significant difference in other indexes (P0.05). The increase of PA in the experimental group was significantly higher than that in the control group (P < 0. 05), and there was no significant difference between the two months after treatment (P < 0. 05). Conclusion 1. The effect of glucocorticoid on reducing bilirubin in infantile cholestatic liver disease was not different from that in routine treatment, but had no significant effect on serum 緯 -GT, nor could it promote TBA excretion effectively. Glucocorticoid can promote the synthesis of prealbumin and contribute to the recovery of hepatocyte function. Clinical treatment of infantile cholestatic liver disease should be combined with the condition of children, rational use of hormones.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R725.7
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