熊去氧胆酸治疗原发性胆汁性肝硬化(初报)。

Vutreshni bolesti Pub Date : 1991-01-01
V Kolarski
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引用次数: 0

摘要

7名女性,平均年龄47.7岁,原发性胆汁性肝硬化(6例II-III期,1例IV期),接受熊去氧胆酸(Ursofalk)治疗,疗程16个月,每日500毫克。在3个月的治疗结束时,3名患者的瘙痒消失了,其余4名患者的瘙痒明显减轻了。所有患者主观主诉、消化不良综合征、食欲和睡眠均有改善。血清胆红素、铜和胆固醇浓度开始下降,碱性磷酸酶、ALAT和ASAT活性也下降。1例患者因过敏反应6个月后停止治疗。治疗16个月后,完成治疗的6例患者瘙痒消失,工作能力提高。血清胆红素、胆固醇、铜和IgG浓度显著下降(p < 0.01),血清碱性磷酸酶、谷氨酰转肽酶、ALAT和ASAT活性降至正常值附近。肝肿大、脾肿大、mcclagan絮凝试验、血清IgM浓度及特异性抗线粒体抗体(M2)滴度均无明显变化。结果表明,熊去氧胆酸作为原发性胆汁性肝硬化的一种治疗手段,可以降低或克服肝内胆汁淤积综合征,并限制肝脏硬化过程的活动。熊去氧胆酸耐受性良好。
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[The treatment of primary biliary liver cirrhosis with ursodeoxycholic acid (preliminary report)].

Seven women, mean age 47.7 years, with primary biliary cirrhosis (6 patients in the II-III stage and I patient in IV stage of the disease) were treated in the course of 16 months with ursodeoxycholic acid (Ursofalk) 500 mg daily. At the end of the 3-d month of treatment the itching had passed in 3 of the patients and in the remaining 4 patients it had substantially decreased. In all patients the subjective complaints, dyspeptic syndrome, appetite and sleep improved. The serum concentrations of bilirubin, copper and cholesterol started to decrease and the serum activity of the enzymes alkaline phosphatase, ALAT and ASAT also decreased. In one patient the treatment was discontinued in the 6-th month because of allergic reaction. After 16 month treatment in the 6 patients who completed the treatment the itching passed and the working capacity improved. The serum concentrations of bilirubin, cholesterol, copper and IgG significantly fell (p less than 0.01), the serum activity of alkaline phosphatase, gamma glutamyl transpeptidase, ALAT and ASAT fell near the upper normal range. The hepatomegaly, splenomegaly, McLagan's flocculation test, serum concentration of IgM and the titer of the specific antimitochondrial antibodies (M2) did not change in spite of the treatment. The results show the ursodeoxycholic acid as a perspective therapeutic means for primary biliary cirrhosis which lowers or overcomes the syndrome of intrahepatic cholestasis and limits the activity of the cirrhotic process in the liver. Ursodeoxycholic acid is well tolerated.

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