抗病毒药物联合治疗慢性病毒性乙型肝炎的临床疗效观察  

Clinical effect of combined use of antiviral drugs on treatment of chronic viral hepatitis B

作　　者：闪海霞[1] 范崇桂[1] 霍丽亚[1] 张怀宏[1] 翟玉峰[1] 

机构地区：[1]南阳市中心医院感染性疾病科,河南南阳473000

出　　处：《中华医院感染学杂志》2016年第10期2267-2269,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(122300410223)

摘　　要：目的探讨干扰素α与苦参素两种抗病毒药物联合治疗慢性病毒性乙型肝炎的疗效与对肝纤维化及免疫功能的影响,为临床治疗提供依据。方法选取2013年4月-2015年4月医院收治的慢性病毒肝炎患者102例,将患者随机分为研究组和对照组,每组各51例,对照组给予干扰素α治疗,研究组给予干扰素α与苦参素联合治疗,比较两组肝功能、肝纤维化指标以及免疫学细胞水平;使用SPSS17.0软件进行统计分析。结果研究组完全应答率54.9%,显著高于对照组的19.6%(P<0.05);治疗前两组谷丙转氨酶(ALT)和谷草转氨酶(AST)比较差异无统计学意义,治疗后两组ALT和AST均显著降低,且研究组低于对照组,比较差异有统计学意义(P<0.05);治疗前两组透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)和层粘连蛋白(LN)比较,差异无统计学意义,治疗后两组HA、Ⅳ-C、PCⅢ和LN均显著降低,且研究组低于对照组,比较差异有统计学意义(P<0.05);对照组治疗前、后CD_4^+、CD8+和自然杀伤细胞(NK)细胞差异无统计学意义,研究组治疗后CD_4^+和NK细胞显著升高,CD8+显著降低,且显著优于对照组,比较差异有统计学意义(P<0.05)。结论干扰素α与苦参素两种抗病毒药物联合治疗慢性病毒性乙型肝炎的疗效确切,能显著改善患者的纤维化和免疫功能,提高完全应答率。OBJECTIVE To explore the clinical effect of combined use of two antiviral drugs（interferon-αand kurarinone）on treatment of chronic viral hepatitis B and observe the influence on liver fibrosis and immune function so as to provide guidance for clinical treatment.METHODS A total of 102 patients with chronic viral hepatitis who were treated in the hospital from Apr 2013 to Apr 2015 were enrolled in the study and randomly divided into the study group and the control group,with 51 cases in each.The control group was treated with interferon-α,while the study group was treated with interferon-αcombined with kurarinone.The liver function,liver fibrosis indexes,and cellular immunological levels were observed and compared between the two groups of patients,and the statistical analysis was performed with the use of SPSS17.0software.RESULTS The complete response rate of the study group was 54.9%,significantly higher than 19.6% of the control group（P〈0.05）.There was no significant difference in the level of alanine aminotransferase（ALT）or aspartate aminotransferase（AST）between the two groups before the treatment;the levels of ALT and AST of the two groups were significantly reduced after the treatment,and the levels of ALT and AST of the study group were lower than those of the control group,and there was significant difference（P〈0.05）.There was no significant difference in the level of hyaluronic acid（HA）,typeⅣ collagen（IV-C）,procollagen Ⅲ（PCⅢ）,or laminin（LN）between the two groups before the treatment;the levels of HA,Ⅳ-C,PCⅢ,and LN of the two groups were remarkably reduced after the treatment and were lower in the study group than in the control group,and there was significant difference（P〈0.05）.There was no significant difference in the level of CD_4~＋,CD8＋,or natural killer cell（NK）in the control group before and after the treatment;the levels of CD_4＋and NK cell were remarkably elevated in the study group after the treatment,while the level of CD8＋was

关 键 词：干扰素Α 苦参素 慢性病毒性乙型肝炎 纤维化 免疫功能 

分 类 号：R512.62[医药卫生—内科学]