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目的 :观察比较二巯基丙磺酸钠 (DMPS)加中药肝豆片、DMPS、依地酸钙钠 (EDTA) 3组治疗对肝豆状核变性 (HLD)肝硬变及肝脏功能的改善作用。方法 :146例患者随机分为A、B、C 3组 ,分别给予DMPS加中药肝豆片、DMPS、EDTA治疗 8周。观察 3组患者治疗前后肝脏声像图、血清蛋白电泳、2 4h尿铜的变化。结果 :A、B、C 3组肝脏声像图改善率分别为 54 0 %、4 4 0 %、39 1% ;A、B两组血清白蛋白较治疗前明显增高 (P <0 0 1,P <0 0 5) ,而C组较治疗前无明显差异。 3组血清γ球蛋白均较治疗前减低 (P <0 0 5) ;3组 2 4h尿铜排出量均较治疗前显著增高 (P <0 0 1) ,而A、B两组的增高较C组更为明显 (P <0 0 5)。结论 :驱铜治疗可通过减轻肝细胞的铜中毒 ,促进HLD肝硬变及肝脏功能的改善。而DMPS加中药肝豆片治疗的改善作用优于DMPS、EDTA的单纯治疗。
OBJECTIVE: To observe the effects of DMPS combined with GDF, DMPS and EDTA on liver cirrhosis and hepatic function in hepatolenticular degeneration (HLD) . Methods: One hundred and sixty-six patients were randomly divided into A, B and C groups. DMPS and DMEG were respectively given for 8 weeks. The changes of liver ultrasonography, serum protein electrophoresis and urinary copper in 24 hours before and after treatment were observed in 3 groups of patients. Results: The improvement rates of liver ultrasonography in group A, B and C were 54 0%, 44 0% and 39 1% respectively. Serum albumin in groups A and B was significantly higher than that before treatment (P <0.01, P <0 05), while there was no significant difference between group C and before treatment. The serum levels of γ-globulin in three groups were significantly lower than those before treatment (P <0.05). The urinary copper excretion in 24 hours in three groups was significantly higher than that before treatment (P <0.01) C group is more obvious (P <0 05). Conclusion: Copper flooding treatment can improve hepatotoxicity and hepatic function in HLD by reducing copper poisoning in hepatocytes. The improvement effect of DMPS plus Chinese medicine liver bean tablets treatment is better than that of DMPS, EDTA alone.