摘要
目的:研究维生素D3对乙型肝炎肝硬化代偿期患者肝功能、肝纤维化指标及免疫因子的影响。方法:选取2014年1月至2019年12月于我院接受治疗的乙型肝炎肝硬化代偿期患者126例,按照随机数字表法分为研究组(n=63)与对照组(n=63),对照组患者行替比夫定治疗,研究组患者在对照组基础上给予维生素D3治疗。观察两组患者治疗前后血清总胆红素(TBil)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)等肝功能指标,血清Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)等肝纤维化指标水平,血清CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)等T细胞水平,HBeAg、HBV DNA等病毒学指标变化情况以及不良反应。结果:治疗后,研究组患者TBil、AST、ALT、PCⅢ、LN、HA、Ⅳ-C水平均低于对照组(P<0.05)。治疗后,研究组患者血清CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平均高于对照组,CD_(8)^(+)水平低于对照组(P<0.05)。治疗后,研究组患者HBeAg转阴率、HBV DNA转阴率、完全应答率均高于对照组(P<0.05)。治疗期间,两组患者不良反应发生率无差异(P>0.05)。结论:维生素D3治疗乙型肝炎肝硬化代偿期患者可有效抑制HBV复制,改善病毒学指标,纠正机体免疫失衡,改善肝功能,抑制肝纤维化,安全可靠。
Objective:To study the effects of vitamin D3 on the compensatory stage of hepatitis B cirrhosis and on liver function,fibrosis index,and immune factors.Methods:A total of 126 patients with CP-HBV treated in our hospital from January 2014 to December 2019 were selected and divided into study group(n=63)and control group(n=63)according to the random number table method.The control group received tibivudine treatment,and the study group received VD3 adjuvant treatment on the basis of the control group.Observe two groups before and after treatment serum total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),etc,which are the indices of liver function,serum levels of collagen type Ⅲ before(PCⅢ),laminin(LN)and hyaluronic acid(HA),type Ⅳ collagen(Ⅳ-C)of liver fibrosis indexes such as level,serum levels of CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),T cell levels.Changes and adverse reactions of virological indexes such as HBeAg,HBV DNA,and complete response.Results:After treatment,the serum levels of TBIL,AST,ALT,PCⅢ,LN,HA,and Ⅳ-C in the study group were all lower than those in the control group(P<0.05).After treatment,the serum CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) levels in the study group were higher than those in the control group,and CD_(8)^(+) levels were lower than those in the control group(P<0.05).After treatment,the HBeAg serological conversion rate,HBeAg negative conversion rate,HBV DNA negative conversion rate and complete response rate in the study group were all higher than those in the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Supplementation with vitamin D3 can effectively inhibit HBV replication,improve virological indexes,correct immune imbalance,improve liver function,and inhibit liver fibrosis,which is safe and reliable.
作者
闫登科
李美娇
黄瑞娜
YAN Deng-ke;LI Mei-jiao;HUANG Rui-na(Department of Gastroenterology,the first people's Hospital of Pingdingshan City(Henan,Pingdingshan,467000),China)
出处
《中西医结合肝病杂志》
CAS
2021年第7期613-615,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
乙型肝炎肝硬化代偿期
维生素D3
替比夫定
肝功能
肝纤维化
免疫因子
compensatory period of hepatitis B cirrhosis
vitamin D3
tibivudine
liver function
liver fibrosis
immune factors
