异甘草酸镁治疗急性药物性肝损伤的疗效观察李异蒋永芳中南大学湘雅二医院感染科邮编410007【摘要】目的：观察异甘草酸镁(天晴甘美)治疗急性药物性肝损伤的疗效。
方法：46例临床确诊为急性药物性肝损伤住院患者随机分为治疗组17例和对照组各29例。
两组均常规给予还原型谷胱甘肽、门冬氨酸钾镁、维生素及氨基酸类等药物治疗,治疗前均停用引起急性药物性肝损伤的药物。
治疗组在此基础上给予异甘草酸镁(天晴甘美)注射液100-150mg静脉滴注,疗程均为4周。
观察两组患者的症状改善情况、肝功能、肝纤维化指标及不良反应。
１月后治疗无效者换用其他治疗。
结果：两组症状体征均有改善，差别无统计学意义。
治疗组治疗后总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转肽酶、透明质酸、层粘连蛋白等指标明显改善,与对照组相比,差别有统计学意义。
治疗组显效率明显高于对照组(P<0.05),且无不良反应。
结论:异甘草酸镁治疗急性药物性肝损伤有较好的疗效。
【关键词】异甘草酸镁；急性药物性肝损伤为探讨异甘草酸镁对药物性肝损伤的疗效，应用异甘草酸镁对药物性肝损伤患者进行了临床治疗观察，现报告如下。
１:对象与方法１.1诊断标准药物性肝损伤定义：采用1990年国际标准［１］血清ALT（谷丙转氨酶）或DBIL（结合胆红素）升高至正常值上限２倍以上，或AST （谷草转氨酶）、ALP（碱性磷酸酶）和TBIL（总胆红素）同时升高，且其中一项指标高于正常值上限２倍以上。
急性药物性肝损伤指以上肝功指标异常持续不超过３个月。
急性药物性肝损伤诊断：按1993年Danan等在总结国际共识会议意见基础上提出的急性药物性肝损伤因果关系评价标准［２］，从服药至发病时间、病程、危险因子、伴随用药、除外其他原因、既往报告、再用药反应等７个方面进行评分，分值在３分或３分以上者诊断为药物性肝损伤。
重症肝炎诊断标准：参照2000年９月西安会议修订的病毒性肝炎防治方案中重症肝炎诊断标准［３］。
异甘草酸镁防治药物性肝损伤的研究进展摘要：药物性肝损伤(DILI)可发生在没有肝脏疾病的人群，或以往有肝脏疾病的患者使用某种药物后发生不同程度的肝损伤。
这些年，随着药物种类越来越多以及新药不断出现和各类保健药物的应用，药物性肝损伤的发病率呈现出一种逐步上升的趋势。
异甘草酸镁是最新一代的甘草酸制剂，在防治药物性肝损伤方面有其优势。
本文通过对异甘草酸镁在抗结核药、抗肿瘤药两类药物所引起的药物性肝损伤的研究现状进行阐述与归纳总结。
关键字：异甘草酸镁；药物性肝损伤；防治Abstract:Drug-induced liver injury (DILI) can occur in people without liver disease, or ever had liver disease patients with certain drugs after different degrees of liver damage. These years, as more and more kinds of drugs as well as new drugs, and new drugs appear constantly and the application of various kinds of health care medicine, the incidence of drug-induced liver injury showing a gradual upward trend. Magnesium isoglycyrrhizinate is the latest generation of licorice acid preparations, has its advantages in prevention and treatment of drug-induced liver injury. In this paper, through research the status of Magnesium isoglycyrrhizinate in anti-TB drugs, antitumor drug-induced two kinds of drugs drug-induced liver injury were described and summarized by.Key words: Magnesium isoglycyrrhizinate; drug-induced liver injury; prophy laxis and treatment目录摘要............................................... 错误！未定义书签。
异甘草酸镁注射液治疗抗结核药物所致急性肝损伤的临床研究郭新枝;陈裕;程俊伟;陈永芳;张晓慧;王志刚;刘宝琴【摘要】This study was designed to evaluate the efficacy and safety of Magnesium Isoglycyrrhizinate Injection to treat acute hepatic dysfunction caused by antituberculosis therapies .In this randomized double-blinded and active drug-controlled clinical study , new pulmonary tuberculosis patients with hepatic dysfunction associated with antituberculosis therapies were recruited and randomly divided into two groups and treated with Magnesium Isoglycyrrhizinate Injection and Tiopronin (another liver function protector ,as a controlled drug) ,respectively .The Magnesium Isoglycyrrhizinate Injection group showed more significant improvement in function parameters of liver than the control group . It was concluded that Magnesium Isoglycyrrhizinate Injection can improve acute hepatic dysfunction associated with antituberculosis therapies .%本文旨在研究用异甘草酸镁注射液治疗抗结核药物所致急性肝损伤的有效性和安全性。
