Madsbad S, Bjerregaard B, Henriksen J H, Juhl E, Kehlet H
Gut. 1980 Jan;21(1):52-6. doi: 10.1136/gut.21.1.52.
Fourteen patients with liver cirrhosis received oral prednisone or prednisolone (0.3 mg per kg) randomised on two consecutive days. Serum prednisone and prednisolone were measured over the following four hours. Mean serum prednisolone concentration after oral prednisone decreased with impaired liver function estimated by galactose elimination capacity (r = 0.64, P less than 0.03). Mean serum prednisolone concentration after oral prednisone in the seven patients with severely impaired liver function was only 53% (P less than 0.05) of that observed in the seven patients with slightly impaired liver function. Conversely, mean serum prednisone concentration after oral prednisone in the patients with severely impaired liver function was 74% higher (P = 0.05) than in patients with slightly impaired liver function. Mean serum prednisolone after oral prednisolone was independent of liver function. As only prednisolone exerts glucocorticoid activity, our results indicate that prednisolone should be preferred to prednisone in the treatment of patients with impaired liver function.
14例肝硬化患者连续两天随机接受口服泼尼松或泼尼松龙（0.3毫克/千克）治疗。在接下来的4小时内测定血清泼尼松和泼尼松龙。口服泼尼松后，平均血清泼尼松龙浓度随通过半乳糖清除能力评估的肝功能损害而降低（r = 0.64，P < 0.03）。7例肝功能严重受损患者口服泼尼松后的平均血清泼尼松龙浓度仅为7例肝功能轻度受损患者的53%（P < 0.05）。相反，肝功能严重受损患者口服泼尼松后的平均血清泼尼松浓度比肝功能轻度受损患者高74%（P = 0.05）。口服泼尼松龙后的平均血清泼尼松龙与肝功能无关。由于只有泼尼松龙具有糖皮质激素活性，我们的结果表明，在治疗肝功能受损患者时，泼尼松龙应优于泼尼松。
