双环醇对慢性乙型肝炎患者肝星状细胞活化和胶原合成的影响

目的:观察双环醇对慢性乙型肝炎(乙肝)患者肝组织炎症、纤维化程度、肝星状细胞活化和胶原合成的影响,探讨其抗纤维化作用机制。方法:20例慢性乙肝患者以双环醇150mg/d治疗24周,治疗前、后分别行肝穿刺活体组织病理学检查,评估治疗前、后肝组织炎症及纤维化程度;并应用免疫组织化学技术和彩色病理图文分析系统观察治疗前、后肝组织内α平滑肌肌动蛋白(α-SMA)、转化生长因子β1(TGF-β1)表达状况和Ⅰ、Ⅲ型胶原含量的变化。结果:慢性乙肝患者经双环醇治疗后,其血清丙氨酸氨基转移酶(ALT)和γ谷氨酰转移酶(γ-GT)水平可显著降低,复常率分别达95%和70%,不仅肝组织炎症和纤维化程度明显改善,且肝组织内α-SMA和TGF-β1的表达强度明显减弱,同时Ⅰ、Ⅲ型胶原的含量也较治疗前明显降低。结论:双环醇治疗可减轻慢性乙肝患者肝脏炎症反应和纤维化程度,同时明显降低肝组织内TGF-β1、α-SMA的表达,阻止肝星状细胞活化和Ⅰ、Ⅲ型胶原的合成,从而发挥抗纤维化作用。

Effect of bicyclol on activation of hepatic stellate cells and collagen synthesis in chronic hepatitis B patients

Objective To observe the effect of bicyclol on hepatic inflammation and fibrosis, activation of hepatic stellate cells and type Ⅰ, type Ⅲ collagen synthesis in chronic hepatitis B patients. Methods A total of 20 patients with chronic hepatitis B were enrolled and bicyclol 150 mg/d was given for 24 weeks. The change of histopathology was observed via liver biopsy before and after treatment of the bicyclol. Immunohistochemical technique and multimedia color pathographic analysis system were applied to observe the expression of （x-smooth muscle actin （α-SMA） and transforming growth factor （TGF）-β, and the synthesis of type Ⅰ, type Ⅲ collagen in the liver tissue. Results After treated with bicyclol, serum levels of alanine aminotransferase （ALT） and γ-glutamyltransferase （γ-GT） decreased significantly, and hepatic inflammation and fibrosis improved significantly. Also, α-SMA and TGF-β1 expression decreased significantly and type Ⅰ, type Ⅲ collagen reduced significantly in the liver tissue after treated with bicyclol. Conclusions Bicyclol treatment can reduce hepatic inflammation and fibrosis, decrease expression of hepatic TGF-β1 and α-SMA, and prevent activation of hepatic stellate cells and synthesis of type Ⅰ, type Ⅲ collagen in the liver tissue, thereby exerts its antifibrosis effect.