S-腺苷蛋氨酸治疗胆汁淤积性肝病伴抑郁/焦虑的临床效果研究

目的:研究S-腺苷蛋氨酸治疗胆汁淤积性肝病伴抑郁/焦虑患者的临床效果。方法:选择2011年3月~2013年3月我院收治的51例不同病因的胆汁淤积性肝病(药物性肝损害13例、慢性乙型肝硬化14例、酒精性肝硬化11例、自身免疫性肝病6例、肝癌5例、胆管癌2例)并抑郁/焦虑的患者,予S-腺苷蛋氨酸1.0 g治疗2周,应用SDS/SAS量表分别评估和比较治疗前后各组患者抑郁/焦虑程度的评分情况。结果:S-腺苷蛋氨酸治疗后,所有组别胆汁淤积性肝病肝病改善的临床总有效率94.12%,其中药物性肝损害、慢性乙型肝硬化、酒精性肝硬化、自身免疫性肝硬化总有效率均为100.00%,肝癌的有效率为60.00%,胆管癌的有效率为50.00%,药物性肝损害患者临床疗效与其他各组有差异(P0.05);药物性肝病患者SDS和SAS评分均较治疗前显著降低(P0.05)。而慢性乙型肝硬化、酒精性肝硬化、自身免疫性肝病、肝癌、胆管癌患者SDS和SAS评分与治疗前相比均无统计学差异(P0.05)。结论:S-腺苷蛋氨酸可改善药物性胆汁淤积性肝病并轻、中度抑郁/焦虑患者的肝功能,并有效减轻其抑郁/焦虑情绪。

Research on S-adenosylmethionine in the Treatment of Patients of Cholestatic Liver Diseases Associated with Anxiety/depression

Objective:To study the clinical effects of S-adenosyl methionine for patients with cholestatic liver disease associated with depression or anxiety.Methods:51 patients with different causes of cholestatic liver diseases (13 cases of drug-induced liver injury, 14 cases of chronic hepatits B cirrhosis, 11 cases of alcoholic cirrhosis, 6 cases of autoimmune liver disease, 5 cases of hepatocellular carcinoma and 2 cases of cholangiocarcinoma) and depression or anxiety were selected in our hospital from March 2011 to March 2013 and treated with intravenous use of S-adenosyl methionine 1.0 g for 2 weeks. Then, Zung''s SDS / SAS assessment were applied to compare the effects in these groups.Results:After treatment with S-adenosylmethionine, the total effetive ratio of all cholestatic liver diseases was 94.12%, including 100.00% in drug-induced liver injury, chronic hepatits B cirrhosis, alcoholic cirrhosis and autoimmune liver disease, 60.00% in hepatocellular carcinoma and 50.00% in cholangiocarcinoma. There was significant statistical differences between drug-induced cholestatic liver disease and the other groups (P<0.05). Scores of SDS and SAS significantly decreased in patients with drug-induced cholestatic liver disease after treated with S-adenosylmethionine (P<0.05), however, it seemed no change in chronic cholestatic liver disease (cirrhosis, autoimmune liver disease) as well as in hepatobiliary cancer (hepatocellular carcinoma, cholangiocarcinoma) .Conclusion:S-adenosylmethionine could improve the liver function in patients with drug-induced cholestatic liver disease associated with mild and moderate depression or anxiety, and effectively better their depressive or anxious mood.