熊去氧胆酸治疗慢性活动性肝炎
Ursodeoxycholic acid therapy in chronic active hepatitis.
作者信息
Bateson M C
机构信息
General Hospital, Bishop Auckland, County Durham, UK.
出版信息
Postgrad Med J. 1990 Sep;66(779):781-3. doi: 10.1136/pgmj.66.779.781.
A 41 year old woman developed chronic active hepatitis with prominent cholestasis. She was treated with prednisolone over 3 years with symptomatic benefit and improvement in serum biochemistry. However, various steroid-related side effects were encountered and steatorrhoea eventually occurred with very troublesome nocturnal diarrhoea. Therapy with ursodeoxycholic acid 750 mg daily was started. Serum alanine aminotransferase and gamma-glutamyl transferase normalized for the first time since her illness began. Steatorrhoea was abolished. There was good control of symptoms as prednisolone therapy was gradually reduced. However, when prednisolone was completely withdrawn there was a prompt biochemical deterioration. Addition of low-dose azathioprine has maintained normal blood tests over 24 months without return of the original symptoms. There are no side effects of ursodeoxycholic acid in subjects without gallstones and this agent may be effective treatment for cholestatic liver disease.
一名41岁女性患慢性活动性肝炎，伴有明显胆汁淤积。她接受泼尼松龙治疗3年，症状得到缓解，血清生化指标有所改善。然而，出现了各种与类固醇相关的副作用，最终发生脂肪泻，并伴有非常麻烦的夜间腹泻。开始每日服用750毫克熊去氧胆酸进行治疗。自患病以来，血清丙氨酸转氨酶和γ-谷氨酰转移酶首次恢复正常。脂肪泻消失。随着泼尼松龙治疗逐渐减少，症状得到了良好控制。然而，当完全停用泼尼松龙后，生化指标迅速恶化。加用小剂量硫唑嘌呤后，在24个月内血液检查一直保持正常，原有症状未复发。在无胆结石的患者中，熊去氧胆酸没有副作用，该药物可能是治疗胆汁淤积性肝病的有效方法。
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