苦参素胶囊联合重组人干扰素对高AFP(甲胎蛋白)慢性乙肝患者纤维化指标及炎症因子的影响

目的:研究苦参素胶囊联合重组人干扰素对高甲胎蛋白(AFP)慢性乙肝患者纤维化指标及炎症因子的影响及治疗效果.方法:将2012年3月~2015年3月于我院接受诊治的96例慢性乙肝肝硬化伴高甲胎蛋白患者,根据治疗方式的不同,随机平均分为A、B、C三组,所有患者均接受复方鳖甲软肝片、水飞蓟宾葡甲胺片、甘草酸二铵保肝抗炎治疗,恩替卡韦抗乙肝病毒治疗,维生素、能量合剂等常规乙肝治疗,A组患者在此基础上给予苦参素胶囊治疗,B组患者给予干扰素-γ 治疗,C组患者给予两种药物联合治疗,治疗9个月,观察三组患者治疗前后肝功能、肝纤维化指标以及炎症因子表达.结果:经过治疗后,三组患者AFP、ALT、AST、TBil、PT均显著降低,白蛋白显著上升;A组HBV-DNA阴转率40.63%,HBeAb阳转率31.25%,HBeAg阴转率34.38%,B组37.50%、28.13%和31.25%,C组65.63%、56.25%和59.38%;三组LN、PCⅢ、PⅣP、HA均显著降低;脾脏厚度、内径,脾静脉宽度,门静脉内径均显著降低;炎症因子IL-6、TNF-α、BFGF及TGF-β1含量均显著降低.A、B两组差异不显著,与C组差异显著.结论:苦参素胶囊联合重组人干扰素可显著降低慢性乙肝患者甲胎蛋白含量,改善肝纤维化状态,降低炎症反应,促进肝功能恢复.

Effects of kushenin capsules combined with recombinant human interferon on fibrosis indexes and inflammatory factors in high AFP (alpha-fetoprotein)patients with chronic hepatitis B

Objective To study effects and treatment effect of kushenin capsules combined with recombinant human interferon on fibrosis indexes and inflammatory factors in high alpha-fetoprotein (AFP)patients with chronic hepatitis B. Methods 96 high alpha-fetoprotein (AFP)patients with chronic hepatitis B liver cirrhosis treated in our hospital from March 2012 to March 2015 were randomly divided into A, B, C three groups according to different treatment methods, all patients received compound Biejia Ruangan tablets, silibin meglumine tablets, diammonium glycyrrhizinate hepatoprotective anti-inflammatory treatment, anluohuaxian capsules jianpi yangwei treatment, entecavir anti-HBV treatment, vitamin, energy mixture and other conventional hepatitis B therapy, A group added kushenin capsules on the basis of the above for 9 months, B group added interferon-γ for 9 months, C group added kushenin capsules and interferon-γ for 9 months, liver function, liver fibrosis indexes and inflammatory factors expression in the three groups before and after the treatment were observed. Results After the treatment, AFP, ALT, AST, TBil, PT in the three groups were significantly decreased, albumin was increased significantly; negative conversion rate of HBV-DNA in A group was 40.63%, positive transfer rate of HBeAb was 31.25%, negative conversion rate of HBeAg was 34.38%, B grouo were 37.50%, 28.13% and 31.25%, C group were 65.63%, 56.25% and 59.38%; LN, PCⅢ, PⅣP, HA in the three groups were significantly decreased; spleen thickness, internal diam-eter, splenic vein widen, internal diameter of portal vein were significantly decreased; inflammatory factor IL-6, TNF-α, BFGF and TGF-β1 content were significantly decreased. There was no significant difference in A and B groups, there was a significant differ-ence compared with C group. Conclusion Kushenin capsules combined with recombinant human interferon can reduce alpha-feto-protein content in patients with chronic hepatitis B significantly, improve hepatic fibrosis status, reduce inflammatory reaction, promote liver function recovery.