还原型谷胱甘肽与异甘草酸镁治疗儿童传染性单核细胞增多症所致轻中度肝酶异常的临床疗效与影响因素研究

Study on Clinical Efficacy and Influencing Factors of Reduced Glutathione and Magnesium Isoglycyrrhizinate in the Treatment of Mild to Moderate Abnormal Liver Enzymes Caused by Infectious Mononucleosis in Children

关键词:  还原型谷胱甘肽  异甘草酸镁  儿童传染性单核细胞增多症  肝酶异常

Key words:  reduced glutathione  magnesium isoglycyrrhizinate  infectious mononucleosis in children  liver enzyme abnormality

摘要:

目的 评价还原型谷胱甘肽（glutathione，GSH）与异甘草酸镁（magnesium isoglycyrrhizinate，YGC）在儿童传染性单核细胞增多症（infectious mononucleosis，IM）所致肝酶异常的临床疗效。方法 采用回顾性研究，将5年收集的儿童IM病例171例分为GSH组、YGC组和联用组。首先对各组病例背景均衡性进行分析，考察各组患儿疾病的恢复情况。其次，比较分析各组用药前后肝酶指标。最后，将组间有显著差异的单因素纳入多重线性回归分析中，评价影响肝酶异常的组内因素。结果 3组治疗肝酶异常的综合疗效恢复率无显著性差异，但YGC组降低谷丙转氨酶（alanine aminotransferase，ALT）水平较联用组显著，降低异常淋巴细胞（abnormal lymphocyte，AL）水平较GSH组显著（P<0.05）。另外对GSH组的相关数据进行多重线性回归分析，体质量和用药时间对肝酶ALT的下降程度有统计学意义（P<0.05）。结论 临床常用剂量3~5 mg·kg^-1的YGC改善IM所致儿童的轻中度肝酶异常疗效显著；GSH降低异常肝酶的程度可能与体质量和用药时间有关。

Abstract:

OBJECTIVE To evaluate the clinical efficacy of reduced glutathione(GSH) and magnesium isoglycyrrhizinate (YGC) in abnormal liver enzymes caused by infectious mononucleosis(IM) in children. METHODS Through retrospective study, 171 cases of IM children in five years were distributed into GSH group, YGC group and combination group. Firstly, background balance of each group was analyzed, disease recovery among three groups was investigated. Secondly, liver enzyme indexes before and after medication were compared. In the end, the single factor which had significant differences was included into multiple linear regression analysis, and factors within a same group influencing protection effect of hepatic protectant for liver enzyme abnormality were evaluated. RESULTS There was no significant difference in the recovery rate of three groups in the treatment of liver enzyme abnormality, but YGC group had alanine aminotransferase(ALT) level significantly lower than that of combination group, and abnormal lymphocyte(AL) level significantly lower than that of the GSH group(P<0.05). In addition, multiple linear regression analysis of the GSH group showed that weight and medication duration had statistical significance in the decreasing of liver enzyme ALT(P<0.05). CONCLUSION The 3-5 mg·kg^-1 of YGC, a commonly used clinical dose, improve mild and moderate liver enzyme abnormality caused by IM in children significantly. The degree of GSH reduce liver enzyme abnormality may be related to body weight and medication duration.