Clinical Focus ›› 2021, Vol. 36 ›› Issue (11): 972-975.doi: 10.3969/j.issn.1004-583X.2021.11.002
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Yang Zhibin1a, Shao Yanfang1a, Pan Li1b, Yang Yanxia1a, Yang Yuxi1b, Zhao Lihui1a, Zeng Rongkun1a, Li Yang1a, Wang Qiaofeng1a, Wang Cong1a, Ma Shiwu2()
Received:
2021-08-02
Online:
2021-11-20
Published:
2021-12-01
Contact:
Ma Shiwu
E-mail:mashiwu@hotmail.com
CLC Number:
Yang Zhibin, Shao Yanfang, Pan Li, Yang Yanxia, Yang Yuxi, Zhao Lihui, Zeng Rongkun, Li Yang, Wang Qiaofeng, Wang Cong, Ma Shiwu. Efficacy of magnesium isoglycyrrhizinate in anti-tuberculosis drug-induced liver injury[J]. Clinical Focus, 2021, 36(11): 972-975.
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.11.002
组别 | 例数 | ALT(U/L) | |||
---|---|---|---|---|---|
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 162.48±26.29 | 99.48±14.52* | 65.96±13.08* | 36.76±7.29* |
对照组 | 25 | 159.76±25.49 | 131.01±24.78* | 90.32±11.61* | 63.56±12.86* |
组间 | F=5.341 P=0.030 | ||||
时点间 | F=47.418 P=0.000 | ||||
组间·时点间 | F=8.586 P=0.001 | ||||
组别 | 例数 | AST(U/L) | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 124.80±21.62 | 68.96±12.16* | 55.60±10.11* | 33.80±6.11* |
对照组 | 25 | 111.40±22.10 | 96.83±18.73* | 75.00±14.79* | 67.68±12.14* |
组间 | F=50.391 P=0.000 | ||||
时点间 | F=14.705 P=0.000 | ||||
组间·时点间 | F=3.408 P=0.035 | ||||
组别 | 例数 | TBIL(μmol/L) | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 14.12±2.71 | 9.04±1.86* | 8.27±1.62* | 8.01±1.60* |
对照组 | 25 | 12.58±2.41 | 9.70±1.66* | 8.72±1.82* | 8.74±1.68* |
组间 | F=0.012 P=0.914 | ||||
时点间 | F=7.953 P=0.001 | ||||
组间·时点间 | F=0.564 P=0.645 |
组别 | 例数 | ALT(U/L) | |||
---|---|---|---|---|---|
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 162.48±26.29 | 99.48±14.52* | 65.96±13.08* | 36.76±7.29* |
对照组 | 25 | 159.76±25.49 | 131.01±24.78* | 90.32±11.61* | 63.56±12.86* |
组间 | F=5.341 P=0.030 | ||||
时点间 | F=47.418 P=0.000 | ||||
组间·时点间 | F=8.586 P=0.001 | ||||
组别 | 例数 | AST(U/L) | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 124.80±21.62 | 68.96±12.16* | 55.60±10.11* | 33.80±6.11* |
对照组 | 25 | 111.40±22.10 | 96.83±18.73* | 75.00±14.79* | 67.68±12.14* |
组间 | F=50.391 P=0.000 | ||||
时点间 | F=14.705 P=0.000 | ||||
组间·时点间 | F=3.408 P=0.035 | ||||
组别 | 例数 | TBIL(μmol/L) | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 14.12±2.71 | 9.04±1.86* | 8.27±1.62* | 8.01±1.60* |
对照组 | 25 | 12.58±2.41 | 9.70±1.66* | 8.72±1.82* | 8.74±1.68* |
组间 | F=0.012 P=0.914 | ||||
时点间 | F=7.953 P=0.001 | ||||
组间·时点间 | F=0.564 P=0.645 |
组别 | 例数 | INF-γ | |||
---|---|---|---|---|---|
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 136.57±28.08 | 68.28±14.82* | 31.70±6.31* | 10.97±1.53* |
对照组 | 25 | 137.01±27.21 | 108.96±20.86* | 62.57±11.40* | 41.79±6.92* |
组间 | F=4.632 P=0.042 | ||||
时点间 | F=33.258 P=0.000 | ||||
组间·时点间 | F=8.791 P=0.001 | ||||
组别 | 例数 | IL-10 | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 6.84±1.04 | 3.42±0.33* | 1.59±0.38* | 1.28±0.21* |
对照组 | 25 | 6.68±1.02 | 4.60±0.83* | 3.53±0.65* | 3.24±0.21* |
组间 | F=24.265 P=0.000 | ||||
时点间 | F=128.602 P=0.000 | ||||
组间·时点间 | F=17.295 P=0.000 | ||||
组别 | 例数 | TNF-α | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 15.04±2.64 | 7.34±1.53* | 3.22±0.61* | 1.24±0.23* |
对照组 | 25 | 11.86±2.40 | 10.35±2.19* | 9.10±1.44* | 6.27±1.16* |
组间 | F=29.298 P=0.000 | ||||
时点间 | F=35.070 P=0.000 | ||||
组间·时点间 | F=13.425 P=0.000 |
组别 | 例数 | INF-γ | |||
---|---|---|---|---|---|
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 136.57±28.08 | 68.28±14.82* | 31.70±6.31* | 10.97±1.53* |
对照组 | 25 | 137.01±27.21 | 108.96±20.86* | 62.57±11.40* | 41.79±6.92* |
组间 | F=4.632 P=0.042 | ||||
时点间 | F=33.258 P=0.000 | ||||
组间·时点间 | F=8.791 P=0.001 | ||||
组别 | 例数 | IL-10 | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 6.84±1.04 | 3.42±0.33* | 1.59±0.38* | 1.28±0.21* |
对照组 | 25 | 6.68±1.02 | 4.60±0.83* | 3.53±0.65* | 3.24±0.21* |
组间 | F=24.265 P=0.000 | ||||
时点间 | F=128.602 P=0.000 | ||||
组间·时点间 | F=17.295 P=0.000 | ||||
组别 | 例数 | TNF-α | |||
治疗前 | 治疗1周 | 治疗2周 | 治疗3周 | ||
观察组 | 25 | 15.04±2.64 | 7.34±1.53* | 3.22±0.61* | 1.24±0.23* |
对照组 | 25 | 11.86±2.40 | 10.35±2.19* | 9.10±1.44* | 6.27±1.16* |
组间 | F=29.298 P=0.000 | ||||
时点间 | F=35.070 P=0.000 | ||||
组间·时点间 | F=13.425 P=0.000 |
组别 | 例数 | 显效 | 有效 | 无效 | 总有效 |
---|---|---|---|---|---|
观察组 | 25 | 22(88.0) | 3(12.0) | 0(0.0) | 25(100.0) |
对照组 | 25 | 14(56.0) | 5(20.0) | 6(24.0) | 19(76.0) |
组别 | 例数 | 显效 | 有效 | 无效 | 总有效 |
---|---|---|---|---|---|
观察组 | 25 | 22(88.0) | 3(12.0) | 0(0.0) | 25(100.0) |
对照组 | 25 | 14(56.0) | 5(20.0) | 6(24.0) | 19(76.0) |
肝功能 指标 | IFN-γ | IL-10 | TNF-α | |||||
---|---|---|---|---|---|---|---|---|
r值 | P值 | r值 | P值 | r值 | P值 | |||
ALT | 0.143 | 0.043 | 0.156 | 0.028 | 0.144 | 0.041 | ||
AST | 0.068 | 0.342 | 0.070 | 0.323 | 0.114 | 0.109 | ||
TBIL | 0.109 | 0.126 | 0.085 | 0.231 | 0.089 | 0.211 |
肝功能 指标 | IFN-γ | IL-10 | TNF-α | |||||
---|---|---|---|---|---|---|---|---|
r值 | P值 | r值 | P值 | r值 | P值 | |||
ALT | 0.143 | 0.043 | 0.156 | 0.028 | 0.144 | 0.041 | ||
AST | 0.068 | 0.342 | 0.070 | 0.323 | 0.114 | 0.109 | ||
TBIL | 0.109 | 0.126 | 0.085 | 0.231 | 0.089 | 0.211 |
[1] | World health organization. WHO Report 2018.[EB/OL]. http://www.who.int/tb/publications/global_report/en/. |
[2] |
Bissel DM, Gores GJ, Laskin DL, et al. Drug-induced liver injury: Mechanisms and test systems[J]. Hepatology, 2001, 33(4):1009-1013.
doi: 10.1053/jhep.2001.23505 URL |
[3] |
Garcia-Cortes M, Robles-Diaz M, Stephens C, et al. Drug induced liver injury: An update[J]. Arch Toxicol, 2020, 94(10):3381-3407.
doi: 10.1007/s00204-020-02885-1 pmid: 32852569 |
[4] |
Ramappa V, Aithal GP. Hepatotoxicity related to anti-tuberculosis drugs: Mechanisms and management[J]. J Clin Exp Hepatol, 2013, 3(1):37-49.
doi: 10.1016/j.jceh.2012.12.001 URL |
[5] |
Devarbhavi H, Aithal G, Treeprasertsuk S, et al. Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines[J]. Hepatol Int, 2021, 15(2):258-282.
doi: 10.1007/s12072-021-10144-3 URL |
[6] |
Yu YC, Mao YM, Chen CW, et al. CSH guidelines for the diagnosis and treatment of drug-induced liver injury[J]. Hepatol Int, 2017, 11(3):221-241.
doi: 10.1007/s12072-017-9793-2 URL |
[7] | 中华医学会肝病学分会药物性肝病学组. 药物性肝损伤诊治指南[J]. 中华肝脏病杂志, 2015, 11(23):810-820. |
[8] | 薄湘晖. 异甘草酸镁治疗抗结核药引起的药物性肝炎临床疗效[J]. 中国现代药物应用, 2017, 11(18):97-98. |
[9] | Shang PH, Xia YY, Liu FY, et al. Incidence, clinical features and impact on anti-tuberculosis treatment of anti-tuberculosis drug induced liver injury (ATLI) in China[J]. PLoS One, 2011, 6(7):e21836. |
[10] | 中华医学会结核病学分会. 抗结核药物性肝损伤诊治指南(2019年版)[J]. 中华结核和呼吸杂志, 2019, 42(5):343-356. |
[11] | 钟洪兰. 抗结核药物致肝损伤的预防与治疗药物选择[J]. 实用医学杂志, 2020, 36(24):3307-3311. |
[12] |
Metushi IG, Zhu X, Chen X, et al. Mild isoniazid-induced liver injury in humans is associated with an increase in Th17 cells and T cells producing IL-10[J]. Chem Res Toxicol, 2014, 27(4):683-689.
doi: 10.1021/tx500013z pmid: 24564876 |
[13] |
Joseph Martin S, Evan Prince S. Comparative modulation of levels of oxidative stress in the liver of anti-tuberculosis drug treated wistar rats by vitamin B12, beta-carotene, and spirulina fusiformis: Role of NF-κB, iNOS, IL-6, and IL-10[J]. J Cell Biochem, 2017, 118(11):3825-3833.
doi: 10.1002/jcb.v118.11 URL |
[14] | Sukhanov DS, Okovityǐ SV, Demidik SN, et al. Relationship between the endogenous interferon IFN-gamma level and risk of hepatotoxic liver damage in tuberculosis patients[J]. Eksp Klin Farmakol, 2012, 75(6):40-43. |
[15] |
Guler R, Olleros ML, Vesin D, et al. Inhibition of inducible nitric oxide synthase protects against liver injury induced by mycobacterial infection and endotoxins[J]. J Hepatol, 2004, 41(5):773-781.
pmid: 15519650 |
[16] | 刘向, 杨丽, 郑甜, 等. 新疆维吾尔族、汉族抗结核药物性肝损伤患者血清IL-10 分泌水平的研究[J]. 中国感染控制杂志, 2019, 18(1):37-41. |
[17] | 麻斌喜, 陈伟岚, 郑甜, 等. 汉族、维吾尔族抗结核药物性肝损害患者血清TNF-α表达水平的研究[J]. 中国医院药学杂志, 2017, 37(24):2456-2459. |
[18] | 孟慧杰, 杨雪迎, 覃红娟, 等. 炎症细胞因子对抗结核性药物肝损伤的预测作用[J]. 实用医学杂志, 2019, 35(2):238-241. |
[19] |
Usui T, Meng X, Saide K, et al. From the cover: characterization of isoniazid-specific T-cell clones in patients with anti-tuberculosis drug-related liver and skin injury[J]. Toxicol Sci, 2017, 155(2):420-431.
doi: 10.1093/toxsci/kfw218 URL |
[20] | 郭春平, 何平, 刘小斌. 异甘草酸镁对抗结核药物性肝损害的疗效[J]. 深圳中西医结合杂志, 2020, 30(24):191-192. |
[21] | 阮军, 尹恒, 寇国先, 等. 异甘草酸镁治疗抗结核药物所致肝损伤疗效的 Meta分析[J]. 药学实践杂志, 2019, 37(4):375-379. |
[22] | 茅益民, 曾民德, 陈勇, 等. 异甘草酸镁治疗ALT升高的慢性肝病的多中心、随机、双盲、多剂量、阳性药物平行对照临床研究[J]. 中华肝脏病杂志, 2009, 17(11) : 847-851. |
[23] |
Wang W, Li XG, Xu J. Magnesium isoglycyrrhizinate attenuates D-galactosamine/ lipopolysaccharides induced acute liver injury of rat via regulation of the p38-MAPK and NF-κB signaling pathways[J]. Immunopharmacol Immunotoxicol, 2018, 40(3):262-267.
doi: 10.1080/08923973.2018.1441300 URL |
[24] |
Liu MM, Zheng B, Liu PP, et al. Exploration of the hepatoprotective effect and mechanism of magnesium isoglycyrrhizinate in mice with arsenic trioxide-induced acute liver injury[J]. Mol Med Rep, 2021, 23(6):438.
doi: 10.3892/mmr URL |
[25] | 詹爱琴, 陈春丽, 朱庆峰, 等. 异甘草酸镁治疗慢性乙型肝炎重度患者外周血Treg Th17 细胞及其相关细胞因子水平变化[J]. 实用肝脏病杂志, 2020, 23(6):793-796. |
[26] | 赖雪莹, 刘斌, 胡学琴, 等. 异甘草酸镁对紫杉醇致大鼠肝损伤的防治作用及其对血清IL-6、IL-10、TNF-α的影响[J]. 中华临床医师杂志(电子版), 2020, 14(11):922-925. |
[27] |
Xie CF, Li XT, Zhu JY, et al. Magnesium isoglycyrrhizinate suppresses LPS-induced inflammation and oxidative stress through inhibiting NF-κB and MAPK pathways in RAW264.7 cells[J]. Bioorg Med Chem, 2019, 27(3):516-524.
doi: 10.1016/j.bmc.2018.12.033 URL |
[28] |
Feng TT, Yang XY, Hao SS, et al. TLR-2-mediated metabolic reprogramming participates in polyene phosphatidylcholine-mediated inhibition of M1 macrophage polarization[J]. Immunol Res, 2020, 68(1):28-38.
doi: 10.1007/s12026-020-09125-9 URL |
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