Clinical characteristics and glutathione treatment of chronic liver injury in patients with coal-burning-borne arsenism / 中华地方病学杂志

ABSTRACT

Objective:To investigate and analyze the clinical characteristics of chronic liver injury and glutathione treatment in patients with coal-burning-borne arsenism.Methods:A total of 71 patients with liver injury caused by coal-burning-borne arsenism admitted to Binzhou People's Hospital from March 2017 to December 2018 were randomly divided into observation group (37 cases) and control group (34 cases) by lottery. Both groups of patients were given routine treatment, including intravenous infusion of compound amino acids, oral administration of B vitamins, etc., and intravenous infusion of 5.0 g of vitamin C mixture dissolved in 250 ml of 5% glucose, once a day, treatment for 4 weeks. In addition, the observation group was given an intravenous infusiondrip of 1.8 g of glutathione dissolved in 250 ml of 5% glucose, once a day, for 4 weeks. The clinical characteristics of the patients were observed, and the changes of liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL)], serum antioxidant indexes [malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)], and clinical efficacy before and after the treatment were compared between the two groups.Results:In 71 coal-burning-borne arsenism patients with liver injury, the abnormal rate of electrocardiogram (ECG) examination was 64.79% (46/71), and the abnormal rate of chest X-ray examination was 26.76% (19/71). After treatment, the liver function indexes ALT, AST, TBIL and DBIL decreased in both groups [observation group before treatment (131.82 ± 25.62), (109.84 ± 26.28) U/L, (81.47 ± 20.93), (57.38 ± 15.25) μmol/L; observation group after treatment (58.93 ± 12.03), (51.20 ± 10.57) U/L, (25.66 ± 7.94), (16.49 ± 4.92) μmol/L; control group before treatment (128.95 ± 31.20), (107.39 ± 29.81) U/L, (83.21 ± 17.95), (55.39 ± 16.30) μmol/L; control group after treatment (76.42 ± 15.73), (74.33 ± 14.80) U/L, (36.72 ± 9.32), (23.74 ± 7.35) μmol/L, P < 0.05], and the liver function indexes in the observation group were significantly lower than those in the control group after treatment ( P < 0.05). The serum antioxidant indexes MDA, SOD and GSH-Px in the two groups were significantly increased after treatment [observation group before treatment (25.47 ± 3.98) μmol/L, (85.72 ± 23.54), (1 729.84 ± 379.50) U/L; observation group after treatment (46.31 ± 7.49) μmol/L, (122.31 ± 28.53), (2 410.29 ± 512.31) U/L; control group before treatment (26.02 ± 4.11) μmol/L, (84.95 ± 21.03), (1 749.52 ± 405.28) U/L; control group after treatment (38.92 ± 6.27) μmol/L, (103.12 ± 25.68), (2 097.42 ± 478.52) U/L, P < 0.05], and the serum antioxidant indexes in the observation group were significantly higher than those in the control group after treatment ( P < 0.05). The total effective rate of the observation group was significantly higher than that of the control group [91.89% (34/37) vs 76.47% (26/34), χ 2 = 4.254, P < 0.05]. Conclusions:Coal-burning-borne arsenism patients with chronic liver injury may have multiple system injury at the same time. Glutathione can effectively improve the clinical symptoms and liver function of patients. Its effect may be related to the improvement of antioxidant function, which is worthy of clinical promotion.