The Clinical Observation On Treatment Of Infantlle Cholestatic Hepatopathy With Glucocorticoid

OBJECTIVE:To compare clinical therapeutic efficacy in infantile cholestatic hepatopathy patient treated with conventional therapy and with glucocorticoid.METHODS:Choose 56 cases of childrens with infantile cholestatic hepatopathy. They were randomly divided into conventional treatment group (control group,28 cases) and GCS treatment group (experimental group,28 cases) by adopting simple number table. The control group was treated with intravenous infusion of succinic acid adenosine methionine and compound glycyrrhizin. The experimental group was treated with intravenous infusion of hydrocortisone sodium succinate on the basis of conventional therapy for 1 week then oral administration of prednisone acetate was given for 2 weeks, total treatment course was 3 weeks. After 3 weeks patients from both groups were treated with oral administration of compound glycyrrhizin and ursodeoxycholic acid, and were followed up at the outpatient clinic at regular intervals to compare the improvement in liver function index of pre- and post-treatment in both groups.RESULTS:1. Liver function in patients from both groups after treatment was improved. In control group after 1 week of treatment TBIL, DBIL (P<0.01) and TBA, ALT (P<0.05) level was decreased; after 3 weeks of treatment, TBIL, DBIL (P<0.01) level was decreased; and after 2 months of treatment, TBIL, DBIL and IBIL (P<0.01) level was decreased. In experimental group which was treated after 1 week the level of TBIL, DBIL (P<0.01) IBIL and PA (P<0.05) was decreased; after 3 weeks of treatment, TBIL, DBIL, IBIL, ALB and PA (P<0.01) level showed significant difference, the other index showed no significant difference (P>0.05).2. There were significant difference of higher PA level after 1 week and 3 weeks of treatment in the experimental group than the control group. After 2 months of treatment, various index of liver function showed no significant differences (P>0.05).CONCLUSIONS:1. There is no significant difference between glucocorticoid and conventional therapy in the long-term effects of treating jaundice in infantile cholestatic liver disease, there is no significant effect on serum y-GT and can not effectively stimulating TBA excretion 2. Glucocorticoid can promote prealbumin synthesis and would be helpful to the liver cell function recovery.3. Clinical treatment of infantile cholestatic hepatopathy should consider children’s condition and rational use of glucocorticoid.