关键词: 淤胆型肝炎, 糖皮质激素, 甘露醇, 总胆红素, 总胆汁酸

Abstract: Objective To investigate the clinical efficacy of glucocorticoid combined with mannitol injection in the treatment of patients with cholestatic hepatitis. Methods 80 patients with cholestatic hepatitis admitted to our hospital from March 2018 to December 2023 were divided into a treatment group (36 cases) and a control group (44 cases). The control group received liver protection, jaundice reduction, treatment of the primary disease, and symptomatic treatment. The treatment group received glucocorticoid combined with mannitol injection on the basis of treatment in the control group. The improvement of liver function indicators, overall effective rate, and adverse reactions before and after treatment were observed in both groups. Results There was no significant difference in the levels of liver function related indicators between the two groups before treatment (P>0.05). After treatment, the levels of TIBL, DBil, ALT, AST, ALP, GGT, and TBA in the treatment group and the control group were (98.2±5.9) μmol/L、(52.6±5.2) μmol/L、(40.1±3.9) U/L、(39.7±2.8) U/L、(98.8±12.5) U/L、(101.2±5.1) U/L、(28.7±8.9) μmol/L, and (116.6± 7.9 )μmol/L、(71.1±6.4) μmol/L、(45.4±4.3) U/L、(44.8±3.7) U/L、(123.7±14.9) U/L、(128.5±9.3) U/L、(49.8±11.7) μmol/L, all of which showed a significant decrease compared to before treatment (P<0.05). Among them, the treatment group showed significantly higher levels of TBil, DBil, ALP, GGT, and TBA than the control group (P<0.05), while there was no significant difference in the decrease of ALT and AST (P>0.05); The overall effective rates of the treatment group and the control group were 83.3% and 68.2%, respectively, with a statistically significant difference (P<0.05); Ten patients in the treatment group experienced excitement and insomnia after using hormones, while five patients experienced discomfort due to venous vessel stimulation after using mannitol for pressurized intravenous infusion, two patients developed redness and swelling, all of them persisted until the end of treatment. Conclusion The combination of low-dose and short course glucocorticoids and mannitol injection can significantly improve liver function indicators, shorten the course of disease, improve prognosis, and have controllable adverse reactions in patients with early cholestatic hepatitis. It can be actively applied in clinical practice.

Key words: Cholestatic hepatitis, Corticosteroids, Mannitol, Total bilirubin, Total bile acids