关键词: 药物性肝损伤, 抗结核药物, 水飞蓟宾, 多烯磷脂酰胆碱, 治疗

Abstract: Objective The aim of this study was to observe the efficacy of silibinin and polyene phosphatidylcholine combination therapy in patients with anti-tuberculosis drugs-induced liver injury (DILI). Methods 118 patients with pulmonary tuberculosis were encountered in our hospital between June 2018 and June 2021, and all received standardized anti-tuberculosis treatment by 2HRS( E) Z /4HR for six months. During the process, 63 patients were found having DILI, and were randomly divided into control (n=30) and observation (n=33) groups, receiving polyene phosphatidylcholine or silibinin capsule and polyene phosphatidylcholine combination therapy until the anti-tuberculosis regimen ended. Serum interleukin-2 (IL-2), IL-6, IL-1β and tumor necrosis factor-α (TNF-α) levels were detected by ELISA, serum superoxide dismutase (SOD) was detected by radioimmunoassay and serum reduced glutathione (GSH) and malondialdehyde (MDA) levels were assayed by biochemical colorimetry. Results After treatment, serum ALT, AST and GGT levels in the observation group were (32.8±6.1)U/L, (41.2±8.3)U/L and (36.1±6.5)U/L, all significantly lower than [(48.6±8.4)U/L, (53.8±9.2)U/L and (53.8±9.6)U/L, respectively, P<0.05] in the control; serum IL-6, IL-1β and TNF-α levels in the observation were (6.3±1.0)ng/L, (11.0±2.3)μg/L and (6.8±1.5)ng/L, all much lower than [(9.5±1.2)ng/L, (19.2±3.6)μg/L and (9.9±1.3)ng/L, respectively, P<0.05] in the control, while there was no significant difference respect to serum IL-2 levels in the two groups (P>0.05); serum SOD and GSH levels in the observation group were (597.3±71.6)U/L and(7.6±1.5)μmol/L, both significantly higher than [(542.8±68.2)U/L and (6.2±1.3)μmol/L, P<0.05], while serum MDA level was (4.0±0.7)nmol/L, much lower than [(5.8±0.9)nmol/L, P<0.05] in the control. Conclusion The administration of silibinin capsule and polyene phosphatidylcholine combination in treatment of patients with pulmonary tuberculosis during anti-tuberculosis therapy could protect the liver function test normal, and maintain the accomplishment of anti-tuberculosis treatment, which might be related to the relieving inflammation and oxidative stress response.

Key words: Drug-induced liver injury, Pulmonary tuberculosis, Anti-tuberculosis medicines, Silibinin, Polyene phosphatidylcholine, Therapy