Journal of Practical Hepatology ›› 2023, Vol. 26 ›› Issue (3): 388-391.doi: 10.3969/j.issn.1672-5069.2023.03.022

• Drug-induced liver injuries • Previous Articles     Next Articles

Efficacy of glycyrrhizic acid diamine and compound glycyrrhizin in the treatment of patients with cyclophosphamide-induced liver injury

Wei Dongping, Han Lili, Ling Jiahui, et al.   

  1. Department of Pharmacy, Tumor Hospital, Nantong 226000,Jiangsu Province, China
  • Received:2022-08-08 Online:2023-05-10 Published:2023-05-08

Abstract: Objective The aim of this study was to compare the efficacy of glycyrrhizic acid diamine and compound glycyrrhizin in the treatment of patients with drug-induced liver injuries (DILI). Methods 97 tumor patients with DILI caused by cyclophosphamide were encountered in Nantong Tumor Hospital between July 2018 and January 2021, and were randomly divided into control group (n=47) and observation group (n=50), receiving compound glycyrrhizin or glycyrrhizic acid diamine, respectively for six months. Serum malonaldehyde (MDA), reduced glutathione (GSH), superoxide dismutase, (SOD) and advanced protein oxidation products (APOPs) levels were detected by purine oxidase; Serum interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), nitric oxide (NO) and macrophage migration inhibitory factor (MIF) levels were determined by ELISA. Results At the end of six month observation, serum bilirubin, ALT and GGT levels in the observation group were(12.3±1.5)μmol/L, (34.9±9.5)U/L and (36.9±8.8)U/L, significantly lower than [(21.7±3.1)μmol/L, (75.3±18.2)U/L and (74.2±15.2)U/L, respectively, P<0.01] in the control; serum TNF-α, IL-6 and MIF levels were (4.1±0.8)ng/ml, (17.6±5.3)pg/ml and (6.0±0.5)ng/mL, significantly lower than [(5.9±1.2)ng/ml,(28.8±6.1)pg/ml and (10.7±0.9)ng/mL, respectively, P<0.01] in the control group; serum MDA and APOPs levels were (4.3±0.7)μmol/L and (2.4±0.2)μmol/L, significantly lower than [(6.4±1.2)μmol/L and (4.3±0.5)μmol/L, P<0.01], while serum SOD and GSH levels were (83.6±7.9)U/L and (7.6±1.5)μmol/L, significantly higher than [(75.2±9.2)U/L and (6.4±1.2)μmol/L, P<0.01] in the control; at the end of one-year follow-up, 25 patients(25.8%) died of malignant tumors in our series. Conclusion The oral administration of glycyrrhizic acid diamine in the treatment of patients with DILI caused by cyclophosphamide is convenient and seems to be more efficacious compared with compound glycyrrhizin, which could improve liver function index normal and inhibit the inflammatory reactions and oxidative stress.

Key words: Drug-induced liver injury, Cyclophosphamide, Glycyrrhizic acid diamine, Compound glycyrrhizin, Therapy