关键词: 自身免疫性肝炎, 硫唑嘌呤, 布地奈德, 泼尼松, 临床缓解, 不良反应

Abstract: Objective To compare the efficacy of budesonide combined with azathioprine and prednisone combined with azathioprine in the treatment of autoimmune hepatitis (AIH).Methods A total of 90 patients with AIH admitted to our hospital from January 2015 to January 2018 were randomly divided into the budesonide group and the prednisone group, 45 cases each. The budesonide group was treated with budesonide plus azathioprine, and the prednisone group was treated with prednisone plus azathioprine. Both groups were treated continuously for 2 years. The total clinical remission rate, serum ALT, AST, ALP, γ-GT levels and the total incidence of adverse reactions were compared between the 2 groups. Results The overall clinical remission rate of the budesonide group was 88.89%, which was significantly higher than 71.11% of the prednisone group (P<0.05). The levels of serum ALT, AST, ALP and γ-GT in the 2 groups after 2 years of treatment were significantly lower than those before treatment (P<0.05). The levels of ALT, AST, ALP and γ - GT in the budesonide group were (27.42 ± 5.36) U/L, (29.97 ± 4.52) U/L, (88.11 ± 14.32) U/L, (49.52 ± 7.62) U/L, respectively, which were significantly lower than those in the prednisone group (P<0.05). The overall incidence of adverse reactions during treatment in the budesonide group was 15.56%, which was significantly lower than 35.56% of the prednisone group (P<0.05).Conclusion Budesonide combined with azathioprine in the treatment of AIH can achieve higher remission rate, more obvious improvement of biochemical indicators, and fewer adverse reactions, which is better than prednisone combined with azathioprine.

Key words: Autoimmune hepatitis, Azathioprine, Budesonide, Prednisone, Clinical remission, Adverse reactions