替米沙坦联合干扰素治疗对慢性乙肝患者肝纤维化的影响

目的:探讨替米沙坦联合干扰素治疗对慢性乙肝患者肝纤维化的影响。方法:选取既往未行抗病毒治疗的HBV-DNA阳性的慢性乙肝患者50例,随机分为观察组及对照组。对照组予以普通干扰素治疗,观察组在普通干扰素治疗的基础上加用替米沙坦80 mg口服,每日一次。治疗周期48周。治疗前后分别行血清肝纤维化指标及肝脏组织病理学检查,并通过免疫组化方法测定TGF-β1、TIMP-1、MMP-1及α-SMA的表达及含量。结果:治疗后,观察组及对照组血清肝纤维化指标(HA、Ⅳ-C、LN、PIIIP)、肝纤维化分级水平及肝纤维化半定量计分较治疗前均下降,且观察组下降更明显,治疗前后,观察组和对照组肝组织中TGF-β1、TIMP-1及α-SMA表达水平明显下降,MMP-1水平明显升高,以观察组变化更为显著。结论:干扰素抗病毒的同时有抗肝纤维化作用,加用替米沙坦后抗肝纤维化作用更明显,提示替米沙坦与干扰素有协同抗纤维化作用。

Effects of telmisartan in combination with interferon againsthepatic fibrosis in patients with hepatitis B

OBJECTIVE To research effects of interferon plus telmisartan against hepatic fibrosis in patients with hepatitis B.METHODS A total of 50 patients with hepatitis B without antiviral therapy administered were randomly divided to treatment group and control group. Patients in treatment group were treated with interferon, patients in control group were treated with interferon combined with telmisartan. TGF-β1, TIMP-1, MMP-1 and α-SMA were detected by immunohistochemistry in hepatic tissues of 50 patients before and 48 weeks after therapy. Hepatic fibrosis indes including HA, Ⅳ-C, LN and PIIIP were observed, as well as histological results of hepatic lesion.RESULTS After treatment, HA, Ⅳ-C, LN and PIIIP in serum were decreased as well as grade level and semiquantitative score of hepatic fibrosis in hepatic tissues; expression levels of TGF-β1, TIMP-1 and α-SMA in hepatic tissues obviously decreased (P <0.05), but expression level of MMP-1 increased (P <0.05). The variation of the treatment group was obvious compared with control group (P <0.05).CONCLUSION Interferon plays an important role in anti-hepatic fibrosis as well as antiviral therapy, when telmisartan is added, the effects of anti-hepatic fibrosis is conspicuous. It indicates that telmisartan and interferon have joint action on anti-hepatic fibrosis.