恩替卡韦联合复方鳖甲软肝片治疗不同时期慢性乙型肝炎肝硬化疗效及其与趋化因子受体的关系  

The relationship between CCR4,CCR6 and the efficacy of entecavir combined with Compound Biejia Ruangan Tablet in the treatment of chronic hepatitis B cirrhosis at different stages

作　　者：朱海洋[1] 高红伟[1] 韩仙芝[1] 张淑凤[1] 刘彦 ZHU Hai-yang;GAO Hong-wei;HAN Xian-zhi;LIU Yan(Department of Gastroenterology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,464000,China;不详)

机构地区：[1]郑州大学第五附属医院消化内科,河南郑州450000 [2]河南中医药大学第一附属医院中医科

出　　处：《中西医结合肝病杂志》2021年第5期405-408,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝硬化不同时期疗效差异,并分析其与趋化因子受体4(CCR4)、趋化因子受体6(CCR6)的关系。方法:选取2016年3月至2019年3月郑州大学第五附属医院收治的180例慢性乙型肝炎肝硬化患者作为研究对象,其中失代偿者60例(失代偿组),代偿者120例(代偿组),所有患者均口服恩替卡韦和复方鳖甲软肝片。比较两组患者治疗前后病毒学指标(HBV DNA)、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBil)]、肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、人Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(Ⅳ-C)]及CCR4和CCR6。结果:治疗前,两组患者血清HBV DNA比较差异无统计学意义(P>0.05);与治疗前比较,治疗后两组患者血清HBV DNA下降明显,差异有统计学意义(P<0.05),但两组治疗后比较差异无统计学意义(P>0.05)。治疗前,失代偿组患者血清ALT、AST和TBil明显高于代偿组(P<0.05);与治疗前比较,治疗后两组患者血清ALT、AST和TBil下降明显,差异有统计学意义(P<0.05),其中失代偿组仍高于代偿组(P<0.05)。治疗前,失代偿组患者血清HA、LN、PCⅢ和Ⅳ-C明显高于代偿组(P<0.05);与治疗前比较,治疗后两组患者血清HA、LN、PCⅢ和Ⅳ-C均明显下降(P<0.05),失代偿组仍高于代偿组(P<0.05)。治疗前,失代偿组患者Th17细胞表面CCR4和CCR6表达量明显高于代偿组(P<0.05);与治疗前比较,治疗后两组患者CCR4和CCR6表达量下降(P<0.05),失代偿组仍高于代偿组(P<0.05)。经Pearson相关分析得知,CCR4和CCR6与HBV DNA、ALT、AST、TBil、HA、LN、PCⅢ和Ⅳ-C均呈明显正相关(P<0.05)。结论:恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝硬化不同时期的患者均有疗效,CCR4和CCR6有望成为疗效评估的有效指标。Objective:To investigate the therapeutic effect of entecavir combined with Compound Biejia Ruangan Tablet in the treatment of chronic hepatitis B cirrhosis in different stages,and to analyze its relationship with chemokine receptor 4(CCR4)and chemokine receptor 6(CCR6).Methods:One hundred and eighty patients with chronic hepatitis B cirrhosis admitted to our hospital from March 2016 to March 2019 were selected as research objects,including 60 cases of decompensated patients(decompensated group)and 120 cases of compensated patients(compensated group).All the research objects were treated with entecavir and Compound Biejia Soft Liver tablet.HBV-DNA,alt,AST and TBIL,ha,LN,PCⅢand IV-C,CCR4,and CCR6 were compared before and after treatment.Results:Before treatment,there was no significant difference between the two groups(P>0.05);compared with before treatment,there was a significant difference between the two groups(P<0.05),but there was no significant difference between the two groups(P>0.05).Before treatment,the serum ALT,AST,and TBIL in the decompensated group were significantly higher than those in the compensated group(P<0.05);compared with before treatment,the serum ALT,AST,and TBIL in the two groups decreased significantly(P<0.05),and the difference was statistically significant(P<0.05),among them,the decompensated group was still higher than that in the compensated group(P<0.05).Before the treatment,the serum HA,LN,PCⅢ,andⅣ-C in the decompensated group were significantly higher than those in the compensated group(P<0.05);compared with before the treatment,the serum HA,LN,PCⅢ,andⅣ-C in the two groups were significantly lower(P<0.05),and the serum HA,LN,PCⅢ,andⅣ-C in the decompensated group were still higher than those in the compensated group(P<0.05).Before treatment,the expression of CCR4 and CCR6 on the surface of Th17 cells in the decompensated group was significantly higher than that in the compensated group(P<0.05);compared with that before treatment,the expression of CCR4 and CCR6 in the de

关 键 词：慢性乙型肝炎肝硬化 恩替卡韦 复方鳖甲软肝片 疗效 趋化因子受体 

分 类 号：R575.2[医药卫生—消化系统]