聂　琦，袁　冶，陶立轩，章　进，代玉环，夏志丹

异甘草酸镁治疗抗结核药物性肝损害150例

聂琦1,2，袁冶1，陶立轩3*，章进2，代玉环2，夏志丹2

[摘要]目的评价异甘草酸镁注射液治疗抗结核药物性肝损害的疗效。方法将抗结核药物性肝损害患者300例随机分为2组，每组150例。治疗组应用异甘草酸镁注射液护肝治疗；对照组应用复方甘草酸苷注射液护肝治疗。比较两组治疗4周后的效果及药物不良反应发生率。结果治疗4周后，治疗组的肝损害总治愈率(98.7%)明显高于对照组(91.3%)，两组比较差异有统计学意义(P<0.01)。由两组治疗后1~4周的治愈率比较得出其整体疗效差异有统计学意义(P<0.01)。对照组药物不良反应发生率为5.33%，治疗组无不良反应发生。结论异甘草酸镁治疗抗结核药物性肝损害治愈率高，不良反应少，且能明显缩短患者治愈时间。

[关键词]异甘草酸镁；抗结核药物；药物性肝损害

[Abstract]ObjectiveTo evaluate the curative effect of magnesium isoglycyrrhizinate (MgIG) injection on liver injury induced by anti-tuberculosis drugs.MethodsThree hundred patients with anti-tuberculosis drug-induced liver injury were randomly divided into two groups.Patients in control group (n=150) were given compound glycyrrhizin injection,while patients in treatment group (n=150) were given MgIG injection.The therapeutic effect and the incidence of adverse drug reactions were compared between the two groups.ResultsThe total effective rate in treatment group was higher than that of control group (98.7% vs.91.3%,P<0.01) after 4 weeks of treatment.The total cure efficacy of treatment group was better than that of control group based on the comparison of the cure rates of each week between the two groups (P<0.01).The rate of adverse drug reactions in control group was 5.33%,while no adverse reaction was observed in treatment group.ConclusionMgIG injection in the treatment of liver injury induced by anti-tuberculosis drugs can obtain high cure rate,with little adverse reaction,it can significantly shorten the cure time.

收稿日期：2015-04-13

DOI:10.14053/j.cnki.ppcr.201512026

Magnesium isoglycyrrhizinate in the treatment of 150 patients with anti-tuberculosis drug-induced liver injuryNIE Qi1,2,YUAN Ye1,TAO Li-xuan3*,ZHANG Jin2,DAI Yu-huan2,XIA Zhi-dan2(1.Wuhan Medical Center Treatment Hospital,Wuhan 430023,China;2.Wuhan University of Science and Technology,Wuhan 430065,China;3.Wuhan Puren Hospital,Wuhan 430081,China)

Key words：Magnesium isoglycyrrhizinate (MgIG);Anti-tuberculosis drug;Drug-induced liver injury

0引言

药物性肝损害是导致抗结核治疗失败的重要原因之一。有报道，抗结核药物引起的药物性肝损害占药物性肝损害的33.7%，乙肝病毒标志物阳性者出现肝功能异常者占35.6%[1]。我国乙肝病毒携带者占人口总数的10%，同时，我国是世界上22个结核病高负担国家之一。有研究者分析了117篇相关文献，发现抗结核药物的不良反应发生率为12.6%，其中肝损害的发生率高达11.9%[2]。异甘草酸镁(江苏正大天晴药业股份有限公司)是第四代甘草酸制剂[3]，其有效成分为18-α异构体甘草酸，较第三代甘草酸制剂复方甘草酸苷注射液具有更强的抗炎、保护肝细胞膜及改善肝功能的作用，且不良反应更少[4]。我科应用异甘草酸镁注射液治疗抗结核药物性肝损害，取得良好疗效，现报道如下。

1资料与方法

1.1病例资料选择2013年1月至2015年1月我科收治的抗结核药物性肝损害患者300例，随机分为2组。……