摘要
目的探讨甘草酸二铵在新型冠状病毒肺炎(COVID-19)合并肝功能异常患者治疗中的临床价值。方法回顾性纳入2020年1月21日至2020年5月18日于首都医科大学附属北京佑安医院住院的COVID-19合并肝功能异常的患者,且上述患者在住院期间因肝功能异常曾使用单药保肝治疗,共入组45例。所有患者均按照《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》进行治疗。观察组患者出现肝功能异常后使用甘草酸二铵治疗,共纳入24例。对照组患者使用其他保肝药治疗,共纳入21例。观察比较两组患者治疗前、治疗后10 d的血常规、肝功能、INR及CRP的变化,并进一步比较两组患者用药后3 d、7 d及10 d的各项指标变化幅度。结果两组患者经保肝治疗后10 d的肝功能、INR均明显好转,淋巴细胞计数升高及CRP下降,差异均有统计学意义(P<0.05)。观察组在使用甘草酸二铵治疗后10 d,其淋巴细胞计数增长幅度及CRP下降幅度均高于对照组(P<0.05)。此外,对照组治疗后3 d、7 d和10 d总胆红素下降幅度明显高于观察组(P<0.05),但两组患者治疗前后胆红素水平均在正常范围内。结论甘草酸二铵治疗COVID-19合并肝功能异常患者,可有效抑制机体的炎症反应,还可保肝、降酶,且安全性高,可为临床治疗提供有效依据。
Objective To investigate the clinical value of diammonium glycyrrhizinate treatment in the patients of COVID-19 combined with abnormal liver function.Methods COVID-19 combined with abnormal liver function patients who were hospitalized in Beijing YouAn Hospital,Capital Medical University from Jan.21 st,2020 to May.18 th,2020 were retrospective analyzed.While the above-mentioned patients have applied the single-drug liver protection treatment due to abnormal liver function during hospitalization with a total of 45 patients enrolled.All patients were treated in accordance with the"Diagnosis and Treatment Plan for COVID-19(Trial Version 5)".Patients in the observation group were treated with diammonium glycyrrhizinate enteric-coated capsules after abnormal liver function with a total of 24 patients enrolled.Patients in the control group were treated with other hepatoprotective drugs,while a total of 21 patients were enrolled.The changes of blood routine,liver function,INR and CRP were observed in each group before and after treatment for 10 days.The change ranges of above indexes in 10 days were compared between the two groups.Results Ten days after treatment,liver function and INR were significantly improved,lymphocyte count was increased and CRP was decreased significantly in each group(P<0.05).After 10 days of diammonium glycyrrhizinate treatment,the lymphocyte growth rate and CRP decrease rate of the observation group were higher than those of the control group(P<0.05).In addition,the decrease range of total bilirubin in the control group was significantly higher than that in the observation group at 3 days,7 days and 10 days after treatment(P<0.05),but the bilirubin levels of the two groups were within the normal range before and after treatment.Conclusion Diammonium glycyrrhizinate in the treatment of patients with COVID-19 with abnormal liver function can effectively inhibit the inflammatory response of human body,as well as protecting the liver,lowering enzymes,which also have high safety and provide effecti
作者
李璐
李爽
陈煜
LI Lu;LI Shuang;CHEN Yu(Hepatology Center Department 4,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China;Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China;Hemodialysis Room,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China)
出处
《胃肠病学和肝病学杂志》
CAS
2020年第10期1162-1166,共5页
Chinese Journal of Gastroenterology and Hepatology
基金
国家重点研发计划资助”(2017YFA0103000)
国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”(2012ZX10002004-006,2017ZX10203201-005,2017ZX10201201-001-001,2017ZX10201201-002-002,2017ZX10201201-004-002,2017ZX10202203-006-001,2017ZX10302201-004-002)
北京市医院管理局“登峰”人才培养计划基金资助项目(DFL20151601)
“北京市医院管理局临床医学发展专项经费资助(ZYLX201806)
白求恩医学科学研究基金资助项目(SG068FN)。
