丹参酮ⅡA磺酸钠治疗日本血吸虫病肝纤维化的长期效果  

Long-term efficacy of sodium tanshinone ⅡA sulfonate in treatment of hepatic fibrosis induced by schistosomiasis japonica

作　　者：徐倩[1] 黄海[1] XU Qian HUANG Hai(Wuxi Ninth People＇s Hospital, Wuxi No. 9 People＇s Hospital Affiliated to Soochow University, Wuxi, Jiangsu 214062, China)

机构地区：[1]无锡市第九人民医院,苏州大学附属无锡九院,江苏无锡214062

出　　处：《中国热带医学》2016年第12期1216-1219,共4页China Tropical Medicine

摘　　要：目的评价丹参酮ⅡA磺酸钠治疗日本血吸虫病肝纤维化的长期效果。方法选择2013—2014年在无锡市第九人民医院接受诊治的57例日本血吸虫病肝纤维化患者为观察对象,给予丹参酮ⅡA磺酸钠注射液静脉注射治疗,1次/d,每次60 mg,连续15 d,治疗前及治疗后6、12个月分别采用彩色多普勒超声诊断仪检测肝实质损害和肝脾肿大情况,并以放射免疫法测定患者血清肝纤维化4项指标。结果经丹参酮ⅡA磺酸钠治疗后,患者肝实质损害显著改善;患者治疗前及治疗后6、12个月门静脉内径分别为(17.2±3.1)mm、(11.2±0.9)mm和(8.6±1.3)mm,脾静脉宽度分别为(10.1±1.7)mm、(6.9±1.5)mm和(4.7±2.1)mm,脾厚度分别为(48.8±4.7)mm、(37.3±6.5)mm和(33.4±3.1)mm,治疗后肝脾超声影像学指标均较治疗前显著改善,差异均有统计学意义(P<0.05)。治疗前及治疗后6、12个月患者血清透明质酸(HA)含量分别为(402.2±31.7)ng/mL、(202.7±11.8)ng/mL和(117.3±10.6)ng/mL,层黏连蛋白(LN)含量分别为(507.8±59.9)ng/mL、(219.6±42.3)ng/mL和(127.6±20.0)ng/mL,Ⅳ型胶原纤维(C-Ⅳ)含量分别为(232.1±37.7)μg/mL、(135.2±9.5)μg/mL和(89.0±10.1)μg/mL,Ⅲ型前胶原肽(PⅢP)含量分别为(210.6±31.3)μg/mL、(112.4±21.5)μg/mL和(100.6±9.7)μg/mL,治疗后4项血清肝纤维化指标均较治疗前显著降低,差异均有统计学意义(P<0.05)。治疗过程中,仅2例患者出现一过性局部皮肤瘙痒。结论丹参酮ⅡA磺酸钠治疗日本血吸虫病肝纤维化长期效果显著,且无明显不良反应,值得临床推广应用。Objective To evaluate the long- term efficacy of sodium tanshinone Ⅱ A sulfonate in the treatment of hepatic fibrosis induced by schistosomiasis japonica. Methods Fifty-seven schistosomiasis japonica patients with hepatic fibrosis were given sodium tanshinone Ⅱ A sulfonate at a single dose of 60 mg by intravenous injection once daily for successive 15 days. Before and after the treatment for 6 and 12 months, the hepatic damage and hepatosplenomegaly were assessed by using a color Doppler ultrasound system, and the serum levels of four hepatic fibrosis-associated parameters were detected by using the radioimmunoassay. Results The treatment with sodium tanshinone Ⅱ A sulfonate significantly improved hepatic damages. The interior diameters of portal vein were（17.2±3.1） mm,（11.2±0.9） mm and（8.6±1.3） mm, the widths of splenic vein were（10.1±1.7） mm,（6.9±1.5） mm and（4.7±2.1） mm, and the thicknesses of spleen were（48.8±4.7） mm,（37.3±6.5） mm and（33.4±3.1） mm before treatment and 6 and 12 months post-treatment, respectively. There were significant improvements in the ultrasonographic parameters of liver and spleen post- treatment as compared to pre- treatment（all P values 0.05）. The serum levels of hyaluronic acid（HA）, laminin（LN）, type Ⅳ collagen（C-Ⅳ） and procollagen Ⅲ peptide（PⅢP） were（402.2±31.7） ng/m L,（202.7±11.8） ng/m L,（117.3±10.6） ng/m L, and（507.8±59.9） ng/m L;（219.6±42.3） ng/m L,（127.6±20.0） ng/m L,（232.1±37.7） μg/m L, and（135.2±9.5） μg/m L;（89.0±10.1） μg/m L,（210.6±31.3） μg/m L,（112.4±21.5） μg/m L,and（100.6±9.7） μg/m L before treatment and 6 and 12 months post-treatment, respectively. The serum levels of four hepatic fibrosis-related parameters were significantly decreased post-treatment as compared to pre-treatment（all P values〈 0.05）.During the treatment period, only two cases developed transient local pruritus. Conclusion Sodium tanshinone Ⅱ A sulfonate show

关 键 词：日本血吸虫病 肝纤维化 丹参酮ⅡA磺酸钠 长期效果 B超 血清学指标 

分 类 号：R532.21[医药卫生—内科学]