Clinical efficacy of glucocorticoid combined with S-adenosyl-L-methionine and ursodeoxycholic acid in the treatment of acute severe drug-induced cholestatic liver disease induced by drugs
Objective To explore the effect of glucocorticoid combined with S-adenosyl-L-methionine(SAMe)and ursodeoxycholic acid(UDCA)in the treatment of drug-induced acute severe drug-induced cholestatic liver disease(DICLD).Methods A total of 106 patients with DICLD treated in the hospital from January 2018 to December 2022 were selected.The patients were divided into 2 groups with 53 cases each by random number table method.The control group was treated with SAMe and UDCA,and the ob-servation group was treated with glucocorticoid(methylprednisolone)combined with SAMe and UDCA.Liver function indexes[(alkaline phosphatase(ALP),total bile acid(TBA),γ-glutamyltransferase(γ-GT),serum bilirubin(TBil)],biochemical indexes[prealbumin(PA)and albumin(ALB)]and immune function indicators[soluble adhesion molecule 1(sVCAM-1)and interferon-y(IFN-y)]were detected af-ter 2 weeks of the treatment.After two weeks of treatment,the clinical efficacy of the two groups was e-valuated.Spearman correlation test was used to analyze the correlation between clinical efficacy and bio-chemical and immune function indexes,and the safety of the two groups of treatment schemes was ob-served.Results The total effective rate was 90.57％in the observation group and 73.58％in the control group(P＜0.05).After the treatment,the levels of ALP,TBA,y-GT,TBil,PA,ALB,sVCAM-1 and IFN-y in both groups were lower than those before the treatment(P＜0.05),the levels of ALP,TBA,γ-GT,TBil,PA,ALB,sVCAM-1 and IFN-γ in the observation group were lower than those in the control group(P＜0.05).Spearman correlation analysis showed that the clinical efficacy was positively correla-ted with the levels of PA and ALB,and negatively correlated with the levels of sVCAM-1 and IFN-γ(all P＜0.05).There was no significant difference in adverse drug reactions between the 2 groups(18.87％vs 11.32％,P＞0.05).Conclusion Glucocorticoids combined with SAMe and UDCA can improve the efficacy of DICLD patients,improve the levels of liver function and inflammatory factors,and enhance the body's immune function,with good safety.
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