Fabris P, Tositti G, Mazzella G, Zanetti A R, Nicolin R, Pellizzer G, Benedetti P, de Lalla F
Department of Infectious Diseases, S. Bortolo Hospital, Vicenza, Italy.
Aliment Pharmacol Ther. 1999 Sep;13(9):1187-93. doi: 10.1046/j.1365-2036.1999.00592.x.
Ursodeoxycholic acid (UDCA) is able to improve biochemical markers of cholestasis, with a parallel decrease in transaminases, in various cholestatic liver diseases.
To evaluate the effects of UDCA administration on acute viral hepatitis-related cholestasis and the course of acute viral hepatitis.
Seventy-nine consecutive patients with acute viral hepatitis (HBV: 43, HCV: 11, HAV: 15, HEV: 3, Non A-E: 7) were randomized to receive either UDCA for 3 weeks or no treatment. Liver biochemistry and serum bile acid determinations were run at weekly intervals.
No significant differences were observed in mean percentage decreases in transaminases between treated and untreated patients. By contrast, cholestatic indexes decreased significantly more quickly in patients treated with UDCA than in controls, and this effect was more evident in patients with increasing alanine transaminase levels at admission. After a peak at the end of the first week of therapy, serum levels of conjugated ursodeoxycholic acid (CUDCA) showed a gradual decrease. Conjugated cholic acid (CCA) and chenodeoxycholic acid (CCDCA) showed a progressive decrease with the resolution of viral hepatitis, but no influence of UDCA administration was observed.
Our study demonstrates that UDCA significantly improves cholestatic indices in patients with acute viral hepatitis, but this effect does not seem to affect the course of the illness.
熊去氧胆酸（UDCA）能够改善各种胆汁淤积性肝病中胆汁淤积的生化指标，同时转氨酶水平会下降。
评估给予UDCA对急性病毒性肝炎相关胆汁淤积及急性病毒性肝炎病程的影响。
79例连续的急性病毒性肝炎患者（乙肝病毒：43例，丙肝病毒：11例，甲肝病毒：15例，戊肝病毒：3例，非甲-戊型：7例）被随机分为接受UDCA治疗3周或不接受治疗两组。每周进行一次肝脏生化检查和血清胆汁酸测定。
治疗组和未治疗组患者转氨酶平均下降百分比无显著差异。相比之下，接受UDCA治疗的患者胆汁淤积指标下降明显快于对照组，且这种效应在入院时丙氨酸转氨酶水平升高的患者中更明显。治疗第一周结束时达到峰值后，结合型熊去氧胆酸（CUDCA）血清水平逐渐下降。随着病毒性肝炎的缓解，结合型胆酸（CCA）和鹅去氧胆酸（CCDCA）呈逐渐下降趋势，但未观察到UDCA给药的影响。
我们的研究表明，UDCA可显著改善急性病毒性肝炎患者的胆汁淤积指标，但这种效应似乎并不影响疾病进程。
