摘要
目的 研究恩替卡韦联合香参抗纤颗粒对慢性病毒性乙型肝炎肝纤维化患者肝脏弹性硬度(LSM)、肝功能、天门冬氨酸氨基转移酶与血小板比率指数(APRI)和血清炎症因子影响。方法 回顾性选取2019年1月至2022年1月长江大学附属仙桃市第一人民医院收治的92例慢性病毒性乙型肝炎肝纤维化患者作为研究对象,根据患者的治疗方法分为试验组(n=46)和对照组(n=46)。对照组给予恩替卡韦治疗,试验组给予恩替卡韦联合香参抗纤颗粒治疗,连续治疗6个月。对比两组患者治疗前、治疗6个月后LSM、肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)和总胆红素]、APRI、血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及C反应蛋白(CRP)]。结果 治疗6个月后,两组患者LSM均较治疗前降低,且试验组LSM为4.69±0.58,显著低于对照组(5.36±0.61),差异有统计学意义(P <0.05)。治疗6个月后,两组患者ALT、AST、总胆红素水平均较治疗前降低,且试验组ALT、AST、总胆红素水平为(32.52±5.08) U/L、(35.12±5.10) U/L、(21.57±5.42)μmol/L,显著低于对照组[(32.52±5.08) U/L、(41.58±5.61) U/L、(30.25±5.21)μmol/L],差异均有统计学意义(P <0.05)。治疗6个月后,两组患者APRI均较治疗前降低,且试验组APRI为0.49±0.13,显著低于对照组(0.89±0.11),差异有统计学意义(P <0.05)。治疗6个月后,两组患者IL-6、TNF-α和CRP水平均较治疗前降低,且试验组IL-6、TNF-α和CRP水平为(4.29±0.88) ng/L、(6.63±1.24) ng/L、(7.63±1.42) mg/L,显著低于对照组[(8.26±0.93) ng/L、(11.21±1.34) ng/L、(9.98±1.35) mg/L],差异均有统计学意义(P <0.05)。试验组不良反应发生率4.34%(2/46)与对照组6.52%(3/46)相比,差异无统计学意义(P> 0.05)。结论 恩替卡韦联合抗纤颗粒治疗慢性病毒性乙型肝炎肝纤维化患者能够有效改善患者LSM、肝功能、APRI和血清炎症因子。
Objective To investigate the effects of entecavir combined with Xiangshen Kangxian granule on liver stiffness measurement(LSM),liver function,aspartate-aminotransferase to platelet ratio index(APRI)and serum inflammatory factors in chronic hepatitis B patients with liver fibrosis.Methods Ninety-two patients with chronic hepatitis B and liver fibrosis in the First People's Hospital of Xiantao from January 2019 to January 2022 were retrospectively enrolled,and divided into two groups according to different treatment methods,each with 46 cases.The control group received entecavir treatment,while the experimental group received entecavir combined with Xiangshen Kangxian granule.After 6 courses of continuous treatment,comparison was conducted on LSM,liver function parameters[alanine transaminase(ALT),aspartic transaminase(AST)and total bilirubin],APRI and serum levels of inflammation factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)].Results After 6 months of treatment,the levels of LSM in the two groups were lower than those before treatment,and the level of LSM in the experimental group was 4.69±0.58,which was significantly lower than that in the control group(5.36±0.61),and the difference was statistically significant(P<0.05).After 6 months of treatment,the levels of ALT,AST and total bilirubin in the two groups were lower than those before treatment,and the levels of ALT,AST and total bilirubin in the experimental group were(32.52±5.08)U/L,(35.12±5.10)U/L,(21.57±5.42)μmol/L,which were significantly lower than those in the control group[(32.52±5.08)U/L,(41.58±5.61)U/L,(30.25±5.21)μmol/L],the differences were statistically significant(P<0.05).After 6 months of treatment,the levels of APRI in the two groups were lower than those before treatment,and the level of APRI in the experimental group was 0.49±0.13,which was significantly lower than that in the control group(0.89±0.11),and the difference was statistically significant(P<0.05).After 6 months of treatment,the levels of IL-6,TNF-αand CRP in the two groups were lower than those before treatment,and the levels of IL-6,TNF-αand CRP in the experimental group were(4.29±0.88)ng/L,(6.63±1.24)ng/L,(7.63±1.42)mg/L,which were significantly lower than those in the control group[(8.26±0.93)ng/L,(11.21±1.34)ng/L,(9.98±1.35)mg/L],the differences were statistically significant(P<0.05).The adverse reaction rate was 4.34%(2/46)in experimental group,which yielded no statistical difference with 6.52%(3/46)in control group(P>0.05).Conclusion Application of entecavir combined with Xiangshen Kangxian granule in the treatment of chronic hepatitis B and liver fibrosis can effectively ameliorate the LSM,liver function,APRI and inflammation factors.
作者
陈卫兵
刘芳
于文虎
CHEN Wei-bing;LIU Fang;YU Wen-hu(Department of Infectious Diseases,the First People's Hospital of Xiantao,Yangtze University,Xiantao Hubei 433000,China)
出处
《临床和实验医学杂志》
2022年第15期1593-1596,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省卫生厅资助项目(编号:JX4B21)。
