熊去氧胆酸治疗异基因造血干细胞移植术后早期-第三军医大学学报.docVIP

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 陈心传，刘 霆，贾永前，何 川，李建军，黄 杰（四川大学华西医院血液内科，四川 成都，610041） 【摘要】　目的: 探讨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的价值。方法:选取2003年～2007年四川大学华西医院行异基因造血干细胞移植术后诊断早期胆汁淤滞性肝病患者26例,续贯入组，随机分为观察组（12 例）和对照组（14 例）。观察组应用熊去氧胆酸口服14mg kg-1·d-1 治疗14 d，对照组S-腺苷蛋氨酸静脉点滴,1g·d-1 , 治疗14d。治疗前后分别检测两组患者总胆红素( TB)、直接胆红素(DB)、谷丙转氨酶(ALT) 、谷草转氨酶(AST) 、(-谷氨酰转肽酶（GGT）及血清碱性磷酸酶（ALP）的含量。结果:观察组显效7例,有效3例, 无效2例, 反应率83.3%; 对照组显效3例,有效3例, 无效8例, 反应率43%; 两组反应率之间差异具有统计学意义(P0.05)。结论: 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安全有效，患者耐受良好。 关键词　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 Ursodeoxycholic acid in treatment of early cholestatic liver disease after allogeneic stem cell transplantation: report of 26 cases CHEN Xin-chuan, LIU Ting, JIA Yong-qian, HE Chuan, LI Jian-jun, HUANG Jie (Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China) 【Abstract】　Objective: To evaluate the effect of rsodeoxycholic acid (UDCA) in cholestatic liver disease at early stage in patients after allogeneic stem cell transplantation. Methods: Twenty-six consecutive cases of cholestatic liver diseases after allogeneic stem cell transplantation were enrolled and randomly divided into 2 groups, the UDCA group (n=12) and the s-adenosyl methionine (n=14). They received conventional pre-transplantation chemotherapy, and regular prevention and treatment 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 h