| 恩替卡韦联合甘草酸二铵治疗慢性乙型肝炎患者效果研究* |
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| 引用本文： | 黄俊榕,吴昌儒,吴健林. 恩替卡韦联合甘草酸二铵治疗慢性乙型肝炎患者效果研究*[J]. 实用肝脏病杂志, 2022, 25(3): 327-330. DOI: 10.3969/j.issn.1672-5069.2022.03.006 |
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| 作者姓名： | 黄俊榕 吴昌儒 吴健林 |
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| 作者单位： | 538021 广西壮族自治区防城港市第一人民医院感染性疾病科(黄俊榕);重症医学科(吴昌儒);广西医科大学附属武鸣医院感染性疾病科(吴健林) |
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| 基金项目： | *广西壮族自治区卫生与健康委员会科研项目(编号:Z20190441) |
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| 摘 要： | 目的 探讨应用恩替卡韦联合甘草酸二铵治疗慢性乙型肝炎(CHB)患者的短期效果和血清细胞因子水平变化。方法 2019年1月～2020年2月我院收治的98例CHB患者,被随机分为对照组49例和观察组49例,两组均接受恩替卡韦治疗,在此基础上,给予观察组加用甘草酸二铵口服,两组均持续治疗观察12个月。采用放射免疫法检测血清透明质酸 (HA) 、层粘连蛋白(LN) 、IV型胶原( CIV) 、III型前胶原(PIIIP) 水平,采用ELISA法检测血清白介素 2(IL- 2)、白介素4(IL- 4)、白介素 10(IL- 10)和肿瘤坏死因子α(TNF-α)水平,使用流式细胞仪检测外周血 T 细胞亚群。结果 在治疗12个月末,观察组血清ALT复常率为87.8%,显著高于对照组的71.4%(P＜0.05);观察组血清ALT和AST水平分别为(32.3±6.9)U/L和(38.3±4.7)U/L,显著低于对照组【分别为(47.5±7.6)U/L和(52.9±5.1)U/L,P＜0.05】;观察组血清HA和PⅢP水平分别为(90.6±9.5)ng/mL和(141.6±32.6)ng/mL,显著低于对照组【分别为(126.8±14.6)ng/mL和(168.2±29.9)ng/mL,P＜0.05】;观察组血清IL-4和TNF-α水平分别为(48.8±7.9)ng/L和(11.3±1.9)ng/L,显著低于对照组【分别为(62.6±8.8)ng/L和(18.5±1.7)ng/L,P＜0.05】,而血清IL-10水平为(19.2±2.5)ng/L,显著高于对照组【(12.7±3.4)ng/L,P＜0.05】;观察组外周血CD4+细胞百分比和CD4+/CD8+细胞比值分别为(43.5±5.5)%和(1.6±0.2),显著高于对照组【分别为(38.4±4.7)%和(1.4±0.4),P＜0.05】。结论 应用恩替卡韦联合甘草酸二铵治疗CHB患者可有效改善患者肝功能,抑制肝纤维化进程,控制体内炎症反应,改善免疫功能紊乱。
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| 关 键 词： | 慢性乙型肝炎 恩替卡韦 甘草酸二铵 治疗 |
| 收稿时间： | 2021-08-01 |
Short-term observation of entecavir and magnesium isoglycyrrhizinate in treatment of patients with chronic hepatitis B |
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| Huang Junrong,Wu Changru,Wu Jianlin. Short-term observation of entecavir and magnesium isoglycyrrhizinate in treatment of patients with chronic hepatitis B[J]. Journal of Clinical Hepatology, 2022, 25(3): 327-330. DOI: 10.3969/j.issn.1672-5069.2022.03.006 |
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| Authors: | Huang Junrong Wu Changru Wu Jianlin |
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| Affiliation: | Department of Infectious Diseases,Frst People's Hospital, Fangchenggang 538021, Guangxi Zhuang Autonomous Region, China |
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| Abstract: | Objective The purpose of this study was to observe the application of entecavir and magnesium isoglycyrrhizinate combination in the treatment of patients with chronic hepatitis B (CHB). Methods A total of 98 patients with CHB were enrolled in our hospital between January 2019 and February 2020, and were randomly divided into control (n=49) and observation group (n=49), receiving entecavir or entecavir and magnesium isoglycyrrhizinate combination therapy for 48 weeks. Serum hyaluronan (HA), laminin (LN), type-IV collagen (CIV) and type-III procollagen (PIIIP) levels were detected by radioimmunoassay. Serum interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 10 (IL-10) and tumor necrosis factor α (TNF-α) levels were detected by ELISA. The peripheral blood T lymphocyte subsets were detected by flow cytometry. Results At the end of 48 week observation, serum ALT normalization rate in the observation group was 87.8%, significantly higher than 71.4%(P＜0.05) in the control; serum ALT and AST levels in the combination group were (32.3±6.9)U/L and (38.3±4.7)U/L, both significantly lower than [(47.5±7.6)U/L and (52.9±5.1)U/L, respectively, P＜0.05] in the control; serum HA and PⅢP levels were (90.6±9.5)ng/mL and (141.6±32.6)ng/mL, both significantly lower than [(126.8±14.6)ng/mL and (168.2±29.9)ng/mL, respectively, P＜0.05] in the control; serum IL-4 and TNF-α levels were (48.8±7.9)ng/L and (11.3±1.9)ng/L, significantly lower than [(62.6±8.8)ng/L and (18.5±1.7)ng/L, respectively, P＜0.05], while serum IL-10 level was (19.2±2.5)ng/L, significantly higher than [(12.7±3.4)ng/L, P＜0.05] in the control; the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells were (43.5±5.5)% and (1.6±0.2), both significantly higher than [(38.4±4.7)% and(1.4±0.4), respectively, P＜0.05] in the control group. Conclusion The application of entecavir and magnesium isoglycyrrhizinate combination in the treatment of patients with CHB could effectively improve liver function test normal, inhibit the process of liver fibrosis, which might be related to the inhibition of inflammatory reaction and modulation of immune system. |
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| Keywords: | Hepatitis B Entecavir Magnesium isoglycyrrhizinate Therapy |
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