熊去氧胆酸辅助治疗婴儿胆汁淤积症62例疗效观察

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目的:对比观察应用熊去氧胆酸(UDCA)辅助治疗婴儿胆汁淤积症的疗效及安全性。方法:回顾性分析62例婴儿胆汁淤积症患儿分为UDCA治疗组与常规保肝药对照组,比较两组治疗前后症状体征和肝生化指标的改善程度;并进一步在UDCA治疗组内对比应答欠佳者与疗效较好者,分析影响因素,并同时观察药物不良反应等情况。结果:UDCA组显效6例,有效21例,无效3例,总有效率为90.0%;对照组显效7例,有效19例,无效6例,总有效率为81.3%。两组治疗后肝功能生化指标均有下降,其中TBIL、AST、ALT治疗前后差异有统计学意义(P<0.05),而两组组间比较差异无统计学意义(P>0.05)。治疗观察期间两组均未见严重不良反应。结论:熊去氧胆酸联合内科综合治疗婴儿胆汁淤积症安全性良好,但与对照组相比未见明显疗效。应答欠佳组与较好应答组相比,因肝病相关临床症状明显就诊者、肝脏生物化学指标明显异常者及可疑代谢异常者可能对熊去氧胆酸的应答欠佳。 Objective: To compare the efficacy and safety of ursodeoxycholic acid (UDCA) in the treatment of infantile cholestasis. Methods: A retrospective analysis of 62 infants cholestasis of infants were divided into UDCA treatment group and conventional hepatoprotective drug control group, before and after treatment to compare the symptoms and signs and liver biochemical indicators of improvement; and further in the UDCA treatment group, the comparative response Poor and those with better efficacy, analysis of the impact of factors, and observed adverse drug reactions and so on. Results: In UDCA group, 6 cases were markedly effective, 21 cases were effective, 3 cases were ineffective, and the total effective rate was 90.0%. In the control group, 7 cases were markedly effective, 19 cases were effective and 6 cases were ineffective. The total effective rate was 81.3%. The biochemical indexes of liver function decreased after treatment in both groups, and the difference was statistically significant (P <0.05) before and after TBIL, AST and ALT treatment. There was no significant difference between the two groups (P> 0.05). During the treatment period, no serious adverse reactions were observed in both groups. Conclusion: Ursodeoxycholic acid combined with medical treatment of infant cholestasis is safe, but no significant effect compared with the control group. Poor responsiveness group compared with the better response group, due to clinical symptoms of liver disease were significantly treated, liver biochemical indicators were significantly abnormal and suspicious metabolic abnormalities may have a poor response to ursodeoxycholic acid.
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