摘要
目的:研究多烯磷脂酰胆碱注射液联合丁二磺酸腺苷蛋氨酸液对肝衰竭患者肝功能、白蛋白及凝血指标的影响.方法:选取2021 年12 月至 2023 年 12 月期间安徽医科大学第一附属医院收治的107 例肝衰竭患者,采用随机数字表法进行完全随机分组,分为对照组(多烯磷脂酰胆碱注射液治疗,n=53)和联合组(多烯磷脂酰胆碱注射液联合丁二磺酸腺苷蛋氨酸液治疗,n=54).对两组肝衰竭患者的治疗效果、肝功能、蛋白相关指标、凝血功能指标及肝衰竭并发症进行比较.结果:联合组治疗总有效率(94.44%)高于对照组(81.13%),差异有统计学意义(P<0.05);治疗4 周后,联合组丙氨酸氨基转移酶(ALT)治疗前后差值为(204.07±22.85)U/L,天冬氨酸氨基转移酶(AST)治疗前后差值为(151.45±30.16)U/L,总胆红素(TBIL)治疗前后差值为(212.10±26.64)μmoL/L,均高于对照组[(189.23±24.70)U/L、(123.03±29.48)U/L、(196.59±23.20)μmoL/L],差异有统计学意义(P<0.05);联合组血清总蛋白(TP)、血清白蛋白(ALB)、前白蛋白(PA)治疗前后差值分别为(7.41±2.26)g/L、(8.53±2.08)g/L、(55.24±10.72)mg/L,均高于对照组[(2.64±1.69)g/L、(4.56±1.75)g/L、(36.18±11.82)mg/L],差异有统计学意义(P<0.05);联合组纤维蛋白原(FIB)、凝血酶原活动度(PTA)、D-二聚体(D-D)治疗前后差值分别为(0.55±0.17)g/L、(24.89±3.92)%、(1.21±0.44)mg/L,均高于对照组[(0.34±0.20)g/L、(18.33±4.06)%、(1.02±0.35)mg/L],差异有统计学意义(P<0.05);两组肝衰竭并发症的发生率比较,差异无统计学意义(P>0.05).结论:多烯磷脂酰胆碱注射液联合丁二磺酸腺苷蛋氨酸液可改善肝衰竭患者的肝功能和凝血功能,联合用药疗效优于单一用药.
Abstract
Objective:To investigate the effects of polyene phosphatidylcholine injection combined with adenosylmethionine butanedisulfonate on liver function,albumin,and coagulation indicators in patients with liver failure.Methods:A total of 107 patients with liver failure treated at The First Affiliated Hospital of An-hui Medical University from December 2021 to December 2023 were selected and randomly divided into a con-trol group(n=53,treated with polyene phosphatidylcholine injection)and a combined group(n=54,treated with polyene phosphatidylcholine injection combined with adenosylmethionine butanedisulfonate).The thera-peutic effects,liver function,protein-related indicators,coagulation function,and complications of liver fail-ure were compared between the two groups.Results:The total effective rate in the combined group(94.44%)was higher than in the control group(81.13%),with a statistically significant difference(P<0.05).After 4 weeks of treatment,the differences in alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)levels before and after treatment were greater in the combined group[(204.07±22.85)U/L,(151.45±30.16)U/L,(212.10±26.64)μmoL/L]compared to the control group[(189.23±24.70)U/L,(123.03±29.48)U/L,(196.59±23.20)μmoL/L〛,with statistical signif-icance(P<0.05).The combined group also showed significantly higher improvements in serum total protein(TP),albumin(ALB),and prealbumin(PA)levels[(7.41±2.26)g/L,(8.53±2.08)g/L,(55.24±10.72)mg/L]compared to the control group[(2.64±1.69)g/L,(4.56±1.75)g/L,(36.18±11.82)mg/L](P<0.05).Additionally,fibrinogen(FIB),prothrombin activity(PTA),and D-dimer(D-D)im-provements in the combined group[(0.55±0.17)g/L,(24.89±3.92)%,(1.21±0.44)mg/L]were grea-ter than those in the control group[(0.34±0.20)g/L,(18.33±4.06)%,(1.02±0.35)mg/L](P<0.05).The incidence of complications of liver failure was not significantly different between the two groups(P>0.05).Conclusion:The combination of polyene phosphatidylcholine injection and adenosylmethionine bu-tanedisulfonate improves liver and coagulation function in patients with liver failure.The combined treatment is more effective than monotherapy.
基金项目
安徽省高等学校科学研究项目(2023AH053290)
维普
万方数据