苦参碱联合干扰素对慢性乙肝纤维化及血清干扰素γ的影响

目的：观察苦参碱联合干扰素对慢性乙肝纤维化症状体征的缓解情况及对血清干扰素γ（IFN-γ）含量的影响。方法：将126例慢性乙型肝炎患者随机分为2组,治疗组66例采用苦参碱联合干扰素治疗,对照组60例采用干扰素治疗,6月后观察2组患者肝功能、乙肝病毒标志物、肝纤维4项及IFN-γ含量。结果：2组均能显著降低血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、透明质酸（HA）、Ⅲ型胶原（PCⅢ）、层黏蛋白（LN）、Ⅳ型胶原（Ⅳ-C）,提高白蛋白/球蛋白比值（A/G）,升高血清IFN-γ含量（P〈0.01）;在降低ALT、AST、HA、PCⅢ、Ⅳ-C方面,治疗组明显优于对照组（P〈0.05）;对照组乙肝病毒脱氧核糖核酸（HBV-DNA）阴转率高于治疗组（P〈0.05）,治疗组乙型肝炎E抗原（HBeAg）阴转率优于对照组（P〈0.01）。结论：苦参碱联合干扰素可升高血清IFN-γ含量,抑制肝纤维化,同时还可抑制病毒复制,促进HBV复制标志物阴转,降低转氨酶,改善肝功能。

Effect of Sophocarpidine Combined with Interferon on Chronic Hepatic Fibrosis and Serum Content of Interferon Gamma in Patients with chronic Type B Hepatitis

Objective：To study the effect of sophocarpidine combined with interferon on hepatic fibrosis and the serum content of interferon gamma（IFN-γ） in chronic hepatitis B（CHB） patients.Methods：A total of 126 CHB patients were randomly divided into two groups.The treatment group（n=66）was given sophocarpidine and interferon,and the control group（n=60） was given interferon.After treatment for 6 months,hepatic function,hepatitis B virus（HBV） serum markers,hepatic fibrosis indexes and IFN-γ were measured.Meanwhile,the pathological changes of hepatic tissue were examined.Results：The serum levels of alanine amino transferase（ALT）,aspartate amino transferase（AST）,hyaluronic acid（HA）,precollagen Ⅲ（PCⅢ）,laminin（LN） and collogen IV（CⅣ） were decreased,and the albumin globulin ratio（A/G） as well as the serum content of IFN-γ was increased in both groups after treatment（P 0.01 compared with those before treatment）.The decrease of serum ALT,AST,HA,PCⅢ and CⅣ was obvious in the treatment group（P 0.05 compared with that in the control group）.The rate for HBV-DNA turning negative was higher（P 0.05） and the rate for HBeAg turning negative was lower in the control group（P 0.01） than those in the treatment group.The pathological changes in the liver tissue of the treatment group were significantly improved.Conclusion：Sophocarpidine combined with interferon could increase the content of IFN-γ,inhibit hepatic fibrosis and viral replication,decrease aminotransferase and improve liver function.