缬沙坦对酒精性肝硬化患者肝纤维化指标的影响

目的：观察缬沙坦对酒精性肝硬化患者临床治疗效果,并探讨其治疗机制.方法：将酒精性肝硬化患者随机分为对照组和治疗组各30例,两组患者均给予戒酒、口服水飞蓟宾70mg/次,Bid,治疗组患者在此基础上加用缬沙坦80mg/d po,疗程3个月.治疗前后检测两组患者血透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原蛋白（Ⅳ-C）、Ⅲ型前胶原肽（PⅢP）以及行肝脏实时组织弹性成像检测;治疗组中20例行肝脏穿刺检查,了解肝纤维化程度有无明显变化.结果：缬沙坦可降低酒精性肝硬化患者的HA、LN（P均＜0.05）,但对患者的Ⅳ-C、PⅢP的影响无统计学意义.肝脏硬度检测指标在治疗后也明显下降（P＜0.01）,但对治疗组20例患者治疗前后行肝脏穿刺,结果未发现其肝纤维化程度有明显变化.结论：服用缬沙坦具有一定的抗肝纤维化作用,但未能证实其可以逆转已形成的肝纤维化.

Clinical effects of valsartan on liver fibrosis indexes in patients with alcoholic liver cirrhosis

Objective： To observe the clinical effects of valsartan on alcoholic cirrhosis and discuss its pathogenesis. Methods： Sixty patients with alcoholic cirrhosis were divided into control group and observation group. Thirty patients in control group received routine treatment for 3 months and thirty patients in observation group received valsartan 80 mg/d based on routine treatment for the same time. Before and after treatment serum HA, LN , PⅢP, IV-C were measured by radioimmunoassay in each group. All patients＇ liver stiffness measurement by realtime tissue elastograhy. Twenty patients＇ liver tissues were obtained by liver biopsy, and then stained by Masson staining and H-E staining before and after using valsartan. Results： Valsartan reduced the concentrations of HA, LN in blood and liver stiffness, but it was not reduced the Ⅳ-C and PⅢP This threatment also cant improved developed liver fibrosis. Conclusion： Valsartan may have the effect of anti-hepatic fibrosis, but it can＇t improved developed liver fibrosis.