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四川大学华西医院血液内科
纸质出版日期:2009,
网络出版日期:2009-02-15,
移动端阅览
陈心传, 刘霆, 贾永前, 等. 熊去氧胆酸治疗异基因造血干细胞移植术后早期胆汁淤滞性肝病观察[J]. 陆军军医大学学报, 2009,31(3):251-253.
CHEN XIN-CHUAN, LIU TING, JIA YONG-QIAN, et al. Ursodeoxycholic acid in treatment of early cholestatic liver disease after allogeneic stem cell transplantation: report of 26 cases. [J]. Journal of army medical university, 2009, 31(3): 251-253.
陈心传, 刘霆, 贾永前, 等. 熊去氧胆酸治疗异基因造血干细胞移植术后早期胆汁淤滞性肝病观察[J]. 陆军军医大学学报, 2009,31(3):251-253. DOI:
CHEN XIN-CHUAN, LIU TING, JIA YONG-QIAN, et al. Ursodeoxycholic acid in treatment of early cholestatic liver disease after allogeneic stem cell transplantation: report of 26 cases. [J]. Journal of army medical university, 2009, 31(3): 251-253. DOI:
目的 探讨熊去氧胆酸(ursodeoxycholic acid ,UDCA)治疗异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation
allo-HSCT)术后早期胆汁淤滞性肝病的价值。 方法 选取2003-2007年本院行allo-HSCT术后诊断早期胆汁淤滞性肝病患者26例
序贯入组,分为观察组(12 例)和对照组(14 例)。观察组应用UDCA口服14 mg·kg
-1
·d
-1
,治疗14 d;对照组S-腺苷蛋氨酸静脉点滴
1 g/d
治疗14 d。治疗前后分别检测2组患者总胆红素(TB)、直接胆红素(DB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(GGT)及血清碱性磷酸酶(ALP)的含量,并观察治疗效果。 结果 观察组显效7例
有效3例
无效2例; 对照组显效3例
有效3例
无效8例。 结论 UDCA治疗allo-HSCT术后早期胆汁淤滞性肝病安全有效,患者耐受良好。
Objective To evaluate the effect of ursodeoxycholic acid (UDCA) in cholestatic liver disease at early stage in patients after allogeneic hematopoietic stem cell transplantation. Methods Twenty-six consecutive cases of cholestatic liver diseases after allogeneic hematopoietic stem cell transplantation were enrolled and randomly divided into 2 groups
the UDCA group (
n
=12) and the s-adenosyl methionine group (
n
=14). They received conventional pre-transplantation chemotherapy
and regular prevention and trea
tment for graft versus host disease. The patients of the UDCA group were taken UDCA tables at a dose of 14 mg·kg
-1
·d
-1
for 14 d
and those out of the other group were intravenously infused with s-adenosyl methionine at a dose of 1 g/d for 14 d. Clinical evaluation and laboratory testing for alanine aminotransferases (ALT)
aspartate aminotransferase (AST)
alkaline phosphatase (ALP)
gamma-glutamyl transpeptidase (GGT)
total bilirubin (TBIL) and direct bilirubin (DBIL) were assessed pre- and post- treatment. TBIL reduced by ≥75%
≥50% or ≤50% were regarded as marked effective
effective or ineffective. Results At the end of the treatment
the 7/12 of patients treated with UDCA had gotten marked effective
the 3/12 gotten effective
whereas 3/12 ineffective. In the s-adenosyl methionine group
ratio of the 3 outcomes were 3/14
3/14 and 8/14 respectively. Compared with pre-therapy
there was a significant decrease in the serum ALT
ALP and GGT levels after treatment in both group (
P
<
0.05). All patients completed their assigned treatment with no major adverse event. Conclusion UDCA therapy appears to be effective
safe and tolerable in individuals with cholestatic liver diseases in allogeneic hematopoietic stem cell transplantation.
异基因造血干细胞移植术胆汁淤滞性肝病熊去氧胆酸S-腺苷蛋氨酸
allogeneic hematopoietic stem cell transplantationcholestatic liver diseasesursodeoxycholic acids-adenosyl methionine
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