复方甘草酸苷对重型肝炎的治疗作用及机制研究.docVIP

复方甘草酸苷对重型肝炎的治疗作用及机制研究 陈耀凯 李 晖*王宇明第三军医大学西南医院全军感染病研究所重庆400038 摘要： 观察复方甘草酸苷对于重型肝炎的治疗作用并探讨其作用机制。 在综合支持疗法的基础上加用复方甘草酸苷注射液治疗重型肝炎患者30例，对照组仅采用相同的综合支持疗法，动态观察两组患者病死率、肝功能指标、血浆内毒素及多种炎性因子水平。 治疗第3周末，治疗组病死率为26.7%（8/30），对照组病死率为43.3%（13/30）；治疗治疗组患者血清ALT及AST水平显著低于对照组；治疗第3周末，治疗组血清总胆红素水平及血浆凝血酶原时间均值显著低于对照组；治疗后各时相点治疗组TNFα水平均显著低于对照组；治疗后第2周及第3周，治疗组患者血浆内毒素及IL-6水平显著低于对照组。 复方甘草酸苷用于治疗重型肝炎，可促进肝功能恢复，可能有助于降低病死率，其机制与降低患者血浆内毒素及细胞因子所致的继发性肝损伤有关。 ：复方甘草酸苷；重型肝炎； Yao-kai, LI Hui, WANG Yu-ming (Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China) Abstract: Objective: To investigate the efficacy of compound glycyrrhizin on patients with serious hepatitis. Methods: Thirty patients in treatment group with serious hepatitis were treated by compound glycyrrhizin and supporting medicines, while thirty patients in control group were treated only with same supporting medicines. Mortality, biochemical parameters, plasma levels of endotoxin and inflammatory factors in patients of both groups were observed during the treatment. Results: By the end of three-week of treatment, eight patients in the treatment group died and the mortality was 26.7% (8/30). Thirteen patients died in the control group and the mortality was 43.3% (13/30). Serum ALT and AST levels in treatment group were significantly lower than that of control group during the treatment. The average levels of serum total bilirubin and plasma prothrombin time in treatment group was lower than that of control group by end of the third treatment week. The levels of tumor necrosis factor alpha in treatment group were lower than that of control group during treatment. The levels of plasma endotoxin and interleukin-6 in treatment group were significantly lower than those of the control group at the second and third treatment week. Conclusion: Compound glycyrrhizin could improve biochemical parameters of patients with serious hepatitis, probably, could improve the survival of patients with severe hepatit