摘要
目的探究熊去氧胆酸(UDCA)对合并肝功能损伤的胆总管结石患者行内镜逆行胰胆管造影(ERCP)取石术后肝功能恢复的影响。方法将2011年1月—2013年12月上海交通大学附属第一人民医院收治的胆总管结石合并肝功能损伤并行ERCP取石术的患者随机分为UDCA组(术后予UDCA 250mg口服,3次/d)和对照组,疗程均为2周。比较两组间和组内治疗前后肝功能指标的差异。结果共106例患者成功取尽结石且无严重并发症发生,每组53例。治疗后2周,UDCA组和对照组患者总胆红素、直接胆红素、碱性磷酸酶、γ-谷氨酰转移酶、丙氨酸转氨酶和天冬氨酸转氨酶(AST)指标均显著低于同组治疗前(P值均<0.05),UDCA组其他肝功能指标(除AST外)均显著低于对照组治疗后(P值均<0.05);对照组术后2周肝功能指标升高者及时加服UDCA治疗4周后肝功能指标均显著低于术前和术后2周(P值均<0.05)。结论ERCP取石术后加用UDCA治疗可有效促进胆总管结石合并肝功能损伤患者肝功能的恢复。
Objective To assess the effect of ursodeoxycholic acid （UDCA） on the liver function recovery in patients with choledocholithiasis and liver damage after endoscopic retrograde cholangiopancreatography （ERCP）. Methods Adult patients with choledocholithiasis and impaired liver function undergoing ERCP in Shanghai First People＇s Hospital from January 2011 to December 2013 were randomly assigned to UDCA group and control group. UDCA （250 mg） or a placebo was orally given 3 times per day after surgery for two weeks. All patients underwent serum liver testing before and after ERCP. The indexes were compared between two groups. Results A total of 106 patients underwent successful ERCP without residual stones or serious complications, with 53 cases in each group. The levels of total bilirubin, direct bilirubin, alkaline phosphatase, gamma-glatamyl transferase, alanine aminotransferase, and aspartate aminotransferase （AST） were significantly decreased at 2 weeks after ERCP in both groups （all P 〈0. 05）. Except for AST, other indexes in the UDCA group were significantly lower than those in the control group （all P〈0.05）. The indexes were significantly decreased in the patients with elevated liver function indexes in the control group after 4-week treatment with UDCA （all P〈0.05）. Conclusion UDCA can effectively promote the liver function recovery in patients with choledocholithiasis and impaired liver function after ERCP.
出处
《上海医学》
北大核心
2017年第8期484-486,共3页
Shanghai Medical Journal
关键词
熊去氧胆酸
胆总管结石
肝功能
临床研究
Ursodeoxycholic acid
Choledocholithiasis
Liver function
Clinical research
