Efficacy of polyene phosphatidylcholine combined with diammonium glycyrrhizinate in the treatment of anti-tuberculosis drug-induced liver injury

Abstract

Abstract: Objective To evaluate the clinical efficacy, safety, and effects on oxidative stress-related biochemical indicators of polyene phosphatidylcholine combined with diammonium glycyrrhizinate in patients with anti-tuberculosis drug-induced liver injury (DILI). Methods A total of 86 patients who diagnosed with DILI during anti-tuberculosis therapy and were hospitalized in our institution between January 2022 and June 2025 were enrolled. According to the hepatoprotective regimen, patients were divided into an observation group (polyene phosphatidylcholine injection + diammonium glycyrrhizinate injection, n=42) and a control group (diammonium glycyrrhizinate injection alone, n=44). The clinical efficacy, safety, and changes in oxidative stress-related biochemical markers were compared between the two groups. Results After 4 weeks of treatment, the levels of ALT, AST, and TBil in the observation group significantly decreased to 38 (28, 50) U/L, 34 (27, 44) U/L, and (18.9±7.6) μmol/L, respectively. The reductions in the observation group were significantly greater than those in the control group [51 (33, 70) U/L, 52 (40, 67) U/L, and (25.1±8.4) μmol/L, all P<0.05]. The average time for ALT to return to normal in the observation group was (12.3±4.1) days, significantly shorter than that in the control group [(18.7±5.6) days, P<0.05]. The overall incidence of adverse events during treatment was 16.7% (7/42) in the observation group and 29.5% (13/44) in the control group, with no statistically significant difference (P>0.05). The proportion of patients progressing to severe DILI in the observation group (2.4%) was significantly lower than that in the control group (13.6%, P<0.05), and the median hospital stay was shorter [7 (5, 9) days vs. 10 (8, 13) days, P<0.05]. After treatment, the reduction in serum MDA in the observation group [(-1.8±0.6) μmol/L] was significantly greater than that in the control group [(-0.9±0.4) μmol/L, P<0.05], and the increase in SOD [(12.5±4.2) μmol/L vs. (6.1±2.8) μmol/L, P<0.05] was also more significant. The 3-month recurrence rates were 4.8% (2/42) in the observation group and 15.9% (7/44) in the control group, with no statistically significant difference (P>0.05). Conclusion Polyene phosphatidylcholine combined with diammonium glycyrrhizinate significantly improves liver function, accelerates liver enzyme recovery, and reduces the incidence of severe liver injury in patients with anti-tuberculosis DILI, with good safety and tolerability.

Key words: Drug-induced liver injury, Anti-tuberculosis drugs, Polyene phosphatidylcholine, Diammonium glycyrrhizinate

DU De-hui, WU An-ni, XING Jing, WANG Yue-kun, LIU Chang. Efficacy of polyene phosphatidylcholine combined with diammonium glycyrrhizinate in the treatment of anti-tuberculosis drug-induced liver injury[J]. Chinese Hepatolgy, 2026, 31(4): 549-552.

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