Ricci P, Hofmann A F, Hagey L R, Jorgensen R A, Rolland Dickson E, Lindor K D
Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Dig Dis Sci. 1998 Jun;43(6):1292-5. doi: 10.1023/a:1018868126743.
We postulated that coadministration of cholylsarcosine with ursodeoxycholic acid might provide additional benefit to primary biliary cirrhosis patients with an incomplete response to ursodeoxycholic acid. Our aim was to test the tolerability and the effect of adjuvant cholylsarcosine on liver tests and plasma cholesterol in primary biliary cirrhosis patients receiving ursodeoxycholic acid. Four primary biliary cirrhosis patients, who, despite more than a year of ursodeoxycholic acid therapy, had one or more liver tests persistently equal to or greater than twice the upper limit of normal, received cholylsarcosine (12-15 mg/kg/day) in addition to ursodeoxycholic acid (13-15 mg/kg/day) for six weeks in an open label study. Values of liver tests and plasma cholesterol, determined every two weeks, remained unchanged. One patient discontinued cholylsarcosine at week 4 because of new-onset pruritus. Analysis of duodenal bile acids in one patient showed 52% enrichment in cholylsarcosine and hydrophilic bile acids constituted 87% of total bile acids. It is concluded that the addition of cholylsarcosine to ursodeoxycholic acid did not influence liver tests in four primary biliary cirrhosis patients who had not responded completely to ursodeoxycholic acid alone. Cholylsarcosine was absorbed and became a dominant biliary bile acid; its administration was associated with increased pruritus.
我们推测，将胆酰肌氨酸与熊去氧胆酸联合使用，可能会给对熊去氧胆酸反应不完全的原发性胆汁性肝硬化患者带来额外益处。我们的目的是测试辅助使用胆酰肌氨酸对接受熊去氧胆酸治疗的原发性胆汁性肝硬化患者的肝脏检查指标和血浆胆固醇的耐受性及影响。在一项开放标签研究中，4例原发性胆汁性肝硬化患者，尽管接受了一年多的熊去氧胆酸治疗，但仍有一项或多项肝脏检查指标持续等于或高于正常上限的两倍，除了熊去氧胆酸（13 - 15 mg/kg/天）外，还接受了六周的胆酰肌氨酸（12 - 15 mg/kg/天）治疗。每两周测定一次的肝脏检查指标值和血浆胆固醇值均未改变。1例患者在第4周因新发瘙痒而停用胆酰肌氨酸。对1例患者十二指肠胆汁酸的分析显示，胆酰肌氨酸富集了52%，亲水性胆汁酸占总胆汁酸的87%。得出的结论是，对于单独使用熊去氧胆酸反应不完全的4例原发性胆汁性肝硬化患者，在熊去氧胆酸基础上加用胆酰肌氨酸对肝脏检查指标没有影响。胆酰肌氨酸被吸收并成为主要的胆汁酸；其使用与瘙痒加重有关。
