熊去氧胆酸与水飞蓟素抗惊厥药物致高转氨酶血症的比较

Inflammation and cell signaling Pub Date : 2015-09-02 DOI:10.14800/ICS.971

M. Asgarshirazi, M. Shariat, S. Mousavi

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引用次数: 2

摘要

肝脏是代谢几乎所有药物和外来物质的中枢器官，因此药物性肝损伤几乎是所有处方药物的潜在并发症。在这项随机开放标签临床试验中，我们比较了熊去氧胆酸(UDCA)与水飞蓟素在抗惊厥药诱导的儿童高转氨酶血症中的有效性和耐受性。水飞蓟素是一种抗氧化剂，UDCA是一种具有肝保护作用的主要胆汁盐。54例年龄在4mo-14岁之间的抗惊厥药诱导的高转氨酶血症儿童，根据分组随机法随机分为两组;他们是在2012年至2014年期间从Valiasr医院儿科神经病学诊所(转诊和公共教育中心)招募的。在随机化之前，排除了其他常见的肝炎原因和解剖异常。任何有病毒、自身免疫或代谢证据或转氨酶水平低于正常上限两倍或未经父母同意的患者均被排除在研究之外。所有患者均未出现功能性肝衰竭。我们使用UDCA(商品名称Ursobil)胶囊250 mg，剂量为10-15 mg/kg/天，每天1次;水飞蓟素(商品名称Livergol)片70 mg，剂量为5 mg/kg/天，每天1次，持续1个月，随访1个月。46例患者(25例男孩，21例女孩)完成了2个月的试验和随访。两组干预前转氨酶水平相似。试验1个月后，除UDCA组的γGT外，两组的转氨酶均显著降低(P< 0.05)。水飞蓟素组3例、UDCA组5例转氨酶恢复正常(AST、ALT低于40 IU/l)。UDCA组与水飞蓟素组比较，水飞蓟素组ALT变化更好(P= 0.017)。这两种药物的耐受性都很好，没有发现任何已知的副作用。关键词:药物性肝炎水飞蓟素熊去氧胆酸

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Comparison between Ursodeoxycholic acid and Silymarin in Anticonvulsive drugs induced Hypertransaminasemia

Liver is the central organ to metabolize almost all drugs and foreign substances so drug -induced liver injury is a potential complication of nearly every medication that is prescribed. In this randomized open-label clinical trial we have compared Ursodeoxycholic acid (UDCA) versus Silymarin effectiveness and tolerability in anticonvulsant induced hypertransaminasemia in children. Silymarin is an antioxidant and UDCA is a primary bile salt with hepatoprotective effects. 54 children aged between 4mo-14yr with anticonvulsant induced hypertransaminasemia were randomized based on block randomization in two groups; they were recruited over two year (2012 to 2014) from Valiasr hospital pediatric neurology clinic, a referral and public educational center. Other common causes of hepatitis and anatomic anomalies were excluded before randomization. Any patient with viral, autoimmune or metabolic evidences or transaminases levels under twice the upper normal limits or without parents' consent was excluded from study. None of patients were suffered from functional liver failure. We used UDCA (with commercial name of Ursobil) capsule 250 mg in dose of 10-15 mg/kg/day once a day and silymarin (with commercial name of Livergol) 70 mg tablet in dose of 5 mg/kg/day once a day for one month and followed our patients for another month. 46 patients (25 boys and 21 girls) completed two months trial and follow up. Pre intervention transaminases quantities were similar in both groups. After one month trial transaminases decreased in both groups significantly (P< 0.05) except for γGT in UDCA group. Normalization of transaminases (AST and ALT less than 40 IU/l) was occurred in 3 patients in silymarin group and 5 patients in UDCA group. Comparing between UDCA and silymarin, ALT changes were better in silymarin group (P= 0.017). Both of them were tolerated well and no known side effects of them seen. Keywords: Drug induced hepatitis-Silymarin-Ursodeoxycholic acid

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Inflammation and cell signaling

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