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  

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

作　　者：甘洪颖[1] 刘敏[2] 胡旭东[1] 龚凤云[1] 夏冰[1] 程海林[1] 柏涛[1] 曲彩红[3] 

机构地区：[1]武汉市医疗救治中心,湖北武汉430023 [2]江汉大学附属医院,湖北武汉430015 [3]中山大学附属第3医院药学部,广东广州510630

出　　处：《中国医院药学杂志》2015年第14期1303-1306,共4页Chinese Journal of Hospital Pharmacy

基　　金：武汉市卫生计生委临床医学科研项目(编号:WX14C74)

摘　　要：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HBVDNA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。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 andα-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 andα-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.

关 键 词：肝纤维化 替米沙坦 干扰素 转化生长因子Β1 金属蛋白酶抑制剂 基质金属蛋白酶 

分 类 号：R969.4[医药卫生—药理学]