摘要
目的：探讨糖皮质激素辅助治疗婴儿肝炎综合征（IHS）的临床疗效及不良反应。方法：收集2009—2012年中山大学附属第三医院和中山大学附属第六医院儿科住院的98例IHS患儿，其中治疗组40例，对照组58例。两组均常规给予还原型谷胱甘肽、葡醛内酯片（肝泰乐）、茵栀黄、维生素等药物治疗，治疗组在常规综合治疗基础上，加用地塞米松0．1～0．2mg／（kg·d）或甲泼尼龙1．0～1．5mg／（kg·d），平均疗程为4周。观察两组肝功能指标转归情况及不良反应情况，分析比较疗效。结果：（1）两组治疗4周后谷草转氨酶（AST）、胆红素（TBIL、DBIL、IBIL）水平均较治疗前下降（P〈0．05），但组间比较差异无统计学意义（P〉0．05）；（2）治疗组总有效率55．0％，对照组70．7％，两组比较差异有统计学意义（P〈0．01）；（3）两组患儿治疗期间均未出现严重不良反应，治疗组感染发生率37．5％（15／40），对照组15．5％（9／58），两组比较差异有统计学意义（P〈0．05）。结论：糖皮质激素辅助治疗IHS虽能够改善肝功能，但疗效并不优于常规综合治疗方案，且易增加其他系统感染风险和不良反应，临床应用时需权衡利弊。
Objective ：To investigate the clinical efficacy and side effects of glucocorticoids on infant with hepatitis syndrome （IHS）. Methods ： Ninety-eight cases of IHS were enrolled during 2009 to 2012, including forty cases of the treatment group and fifty-eight cases of the control group. Both groups received glutathione, glucurolactone, Yinzhihuang, vitamin and other treatments ; the treatment group received dexamethasone 0.1 -0.2 mg/（ kg · d） or methylprednisolone 1.0 - 1.5 mg/（ kg · d） for four weeks. The liver functions and adverse reactions before and after treatment were analyzed. Results： （1） Liver function （AST, TBIL, DBIL, IBIL） were statistically significant improved in the two groups after treatment, but the results of the treatment group were not better than those of the control group （P〉0.05） ; （2） The total effectiveness of the treatment group and the control group were 55.0% and 70.7%, respectively; the difference was statistically significant （ P 〈 0.01 ） ; （ 3 ） There were no serious adverse events occurred during treatment in the two groups; the infection rates of the treatment group and the control group were 37.5% （15/40） and 15.5% （9/58）, respectively; there was a difference between the two groups （P〈0.05）. Conclusions： Glucocorticoid therapy in the treatment of IHS can improve liver function, but the effect is not superior to comprehensive treatment. The benefits and side effects need to be evaluated for using glucocorticoid.
出处
《儿科药学杂志》
CAS
2014年第4期15-17,共3页
Journal of Pediatric Pharmacy
关键词
婴儿肝炎综合征
糖皮质激素
不良反应
疗效
Infant hepatitis syndrome
Glucocorticoid
Adverse reaction
Curative effect
