关键词: 熊去氧胆酸, 慢性药物性肝病, 疗效分析

Abstract: Objective To investigate the treatment efficacy of ursodeoxycholic acid (UDCA) in chronic drug-induced liver injury (DILI) and its histopathology characteristics. Methods In the retrospective analysis, 49 cases were divided into treatment group who received UDCA (750 mg/d) combined with basic therapy, and control group who received only the basic therapy. Therapeutic efficacy and liver function indicators were observed at month 3 and 6. Cure rates in the 2 groups were evaluated at month 6, and liver biopsies were conducted in patients who failed to response to the therapy for evaluating the histopathology progress. Results In treatment group, mean levels of total bilirubin (TBil), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT) were 56.17 μmol/L and 19.42 μmol/L, 129.64 U/L and 72.79 U/L, 101 U/L and 71 U/L at month 3 and 6, respectively, which were significantly lower than that in control group (P<0.05). However, alanine aminotransferase (ALT) level showed no significantly difference between the 2 groups (P>0.05). Treatment group showed significantly higher therapeutic efficacy than control group at month 3 (P<0.05), but not at month 6 (P>0.05). Nevertheless, the non-response rate in treatment group (8.7%) was obviously lower than that in control group at month 6 (23.1%) (P<0.05). The histopathology appeared to be portal area inflammation accompanied with hepatocyte adipose degeneration in treatment group, while portal bile duct hyperplasia, hepatic steatosis and hepatocyte cholestasis in control group. Conclusion UDCA could effectively improve liver function and reduce inflammation and cholestasis in patients with chronic DILI, and then increases the cure rate and postpones the histopathology progress of liver tissue.

Key words: Ursodeoxycholic acid, Chronic drug-induced liver injury, Analysis of clinical therapeutic effect