Shepard M J, Bracken M B
Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, Connecticut 06520-8034.
Paraplegia. 1994 Apr;32(4):236-45. doi: 10.1038/sc.1994.43.
In order to determine the impact of extremely large doses of methylprednisolone, naloxone, or of spinal cord injury itself, on liver enzymes, we examined the results of SGOT, SGPT, alkaline phosphatase and total bilirubin tests obtained 24 hours, 3 and 10 days after the end of the study drug infusions in spinal cord injured patients entered in the National Acute Spinal Cord Injury Study. The mean values of four liver enzymes, the amount of change between 24 hours and 3 and 10 days post infusion, and the proportion of liver enzyme levels considered to be abnormal did not appear to be affected by either drug protocol. Even when controlling for drug protocol and severity of injury (complete vs incomplete), variation in enzyme levels appeared to be the result of the spinal cord injury, not study drugs. Spinal cord injury is routinely treated with the NASCIS dose of methylprednisolone in many countries. It is reassuring to find no evidence of compromised liver function from this steroid protocol.
为了确定超大剂量的甲基强的松龙、纳洛酮或脊髓损伤本身对肝酶的影响，我们检查了参与国家急性脊髓损伤研究的脊髓损伤患者在研究药物输注结束后24小时、3天和10天获得的谷草转氨酶（SGOT）、谷丙转氨酶（SGPT）、碱性磷酸酶和总胆红素测试结果。四种肝酶的平均值、输注后24小时与3天及10天之间的变化量，以及被认为异常的肝酶水平比例似乎不受任何一种药物方案的影响。即使在控制药物方案和损伤严重程度（完全性与不完全性）时，酶水平的变化似乎也是脊髓损伤的结果，而非研究药物所致。在许多国家，脊髓损伤通常采用国家急性脊髓损伤研究（NASCIS）剂量的甲基强的松龙进行治疗。发现该类固醇方案没有损害肝功能的证据，这让人放心。
