熊去氧胆酸联合骨化三醇治疗原发性胆汁性肝硬化患者疗效和外周血T淋巴细胞亚群的变化*

目的 探讨应用熊去氧胆酸(UCDA)联合骨化三醇治疗原发性胆汁性肝硬化(PBC)患者的疗效及其对外周血T淋巴细胞亚群的影响。方法 2015年6月～2018年6月我院消化内科治疗的100例PBC患者,被随机分为观察组和对照组,每组50例。给予对照组UDCA治疗,给予观察组UDCA联合骨化三醇胶丸治疗,观察1年。结果 在治疗1年末,观察组应答36例(72.0%),显著高于对照组的26例(52.0%,P<0.05);观察组血清ALP水平为(132.6±37.9)U/L,显著低于对照组【(151.6±47.1)U/L,P＜0.05】,GGT水平为(162.8±17.8) U/L,显著低于对照组【(189.7±18.0) U/L,P＜0.05】,TBA水平为(12.0±1.7)μmol/L,显著低于对照组 【(16.2±2.1)μmol/L,P＜0.05 】;观察组血清25-(OH)2-D3为(19.0±4.5)ng/mL,显著高于对照组的【(11.2±3.8)ng/mL,P＜0.05】,CD4⁺细胞百分比为(3.4±1.1)%,显著高于对照组【(3.0±0.8)%,P＜0.05】,Th17细胞百分比为(1.5±0.8)%,显著低于对照组【(1.9±1.0)%,P＜0.05】;观察组和对照组血清DAO水平分别为(3.3±1.1)U/mL和(4.0±1.7)U/mL,D-乳酸水平分别为(2.1±1.6)mmol/L和(2.5±2.0)mmol/L,内毒素水平分别为(0.4±0.1)EU/mL和(0.6±0.2)EU/mL,均差异显著(P＜0.05)。结论 应用UDCA联合骨化三醇胶丸能显著改善PBC患者肝功能指标,降低血清内毒素水平。

Efficacy of ursodeoxycholic acid combined with calcitriol in treatment of patients with primary biliary cirrhosis

Objective The aim of this study was to investigate the efficacy of ursodeoxycholic acid( UDCA) combined with calcitriol in treatment of patients with primary biliary cirrhosis( PBC). Methodsm 100 patients with PBC were randomly divided into observation and control group with 50 cases in each group. The patients in the control group was treated with UDCA,while those in the observation group was treated with UDCA combined with calcitriol capsules for one year. Result At the end of one year treatment,the response rate in the observation was 72.0%,much higher than 52.0%( P< 0.05) in the control;serum ALP level was( 132.6±37.9) U/L,significantly lower than 【( 151.6±47.1) U/L,P<0.05】,serum GGT level was( 162.8±1 7.8)U/L,much lower than 【( 189.7±18.0) U/L,P<0.05】,serum TBA level was( 12.0±1.7) $mol/L,significantly lower than 【( 16.2±2.1) $mol/L,P< 0.05 】in the control;serum 25-hydroxyvitamin D3 level was( 19.0± 4.5) ng/m L,significantly higher than【( 11.2±3.8) ng/m L,P<0.05】,the percentage of peripheral blood CD4^+ cells was( 3.4±1.1) %,significantly higher than 【( 3.0±0.8) %,P<0.05】,that of Th17 cells was( 1.5± 0.8) %,much lower than 【( 1.9± 1.0) %,P< 0.05】in the control;there were significant differences as respect to serum diamine oxidase ( 3.3 ± 1. 1) U/m L vs.( 4. 0 ± 1. 7) U/m L],lactic acid ( 2. 1 ± 1. 6)mmol/L vs.( 2.5±2.0) mmol/L]and endotoxin ( 0.4±0.1) EU/m L vs.( 0.6±0.2) EU/m L]levels in the two groups( all P<0.05).Conclusion The application of UDCA and calcitriol combination might greatly improve liver functions in PBC patients.