更昔洛韦联合还原型谷胱甘肽对巨细胞病毒性肝炎患者肝功能及Th1/Th2平衡的影响  

Effects of ganciclovir combined with reduced glutathione on liver function and Th1/Th2 balance in patients with cytomegalovirus hepatitis

作　　者：丁光伟 段淑芬 高春耕 王全智 DING Guang-wei;DUAN Shu-fen;GAO Chun-geng(Department of Gastroenterology,Xuchang Central Hospital of Henan Province(Xuchang,Henan,461000),China.)

机构地区：[1]河南省许昌市中心医院消化内科,河南许昌461000

出　　处：《中西医结合肝病杂志》2021年第5期424-427,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:观察更昔洛韦联合还原型谷胱甘肽治疗巨细胞病毒性肝炎患者的疗效,分析药物联合方案对患者肝功能及Th1/Th2平衡的影响。方法:采集我院2018年1月至2020年4月期间收治的98例巨细胞病毒性肝炎患者的临床资料,根据治疗方案进行分组,对照组患者40例,采用基础治疗+还原型谷胱甘肽治疗;观察组患者58例,采用基础治疗+还原型谷胱甘肽+更昔洛韦治疗。治疗结束后,记录并对比两组患者肝功能:谷草转氨酶(AST)、谷丙转氨酶(ALT);巨细胞病毒DNA(CMV-DNA);Th1/Th2型细胞因子:干扰素-γ(IFN-γ)、白细胞介素-18(IL-18)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)与免疫功能相关指标:自然杀伤细胞(NK)及T细胞亚群(CD_(4)^(+)/CD_(8)^(+))水平,记录患者治疗期间不良反应发生率。结果:治疗结束后,相较于对照组,观察组患者AST、ALT水平与CMV DNA(CMV DNA)、IFN-γ、TNF-α水平均降低,IL-18、IL-10、CD_(4)^(+)/CD_(8)^(+)、NK水平均升高,观察组患者CMV DNA转阴时间较短,差异有统计学意义(P<0.05);治疗期间两组患者不良反应差异无统计学意义(P>0.05)。结论:巨细胞病毒性肝炎患者在基础治疗条件下,给予更昔洛韦联合还原型谷胱甘肽治疗,对恢复患者肝功能、促进机体免疫、改善Th1/Th2细胞因子平衡网络系统疗效显著,且联合用药方案并不会增加药物不良反应发生率,用药安全可靠。Objective:To observe the benefits of ganciclovir combined with reduced glutathione in the treatment of patients with cytomegalovirus hepatitis,mainly to analyze the effect of drug combination regimen on liver function and Th1/Th2 balance of patients,in order to guide the future of this type of treatment of diseases.Methods:Retrospective analysis,collected clinical data of 98 cases of cytomegalovirus hepatitis admitted in our hospital from January 2018 to April 2020,and divided them according to the treatment plan.The control group(40 cases,basic treatment+reduced glutathione)Peptide,observation group(58 cases,basic treatment+reduced glutathione+ganciclovir),after treatment,recorded and compared the liver function of the two groups(total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and cytomegalovirus(CMV-DNA),Th1/Th2 type cytokines(InterferoN-γ(IFN-γ),interleukiN-18(IL-18),interleukiN-10(IL-10),tumor necrosis factor-α(TNF-α))and immune functioN-related indicators(natural killer cells(NK)and T cell subsets(CD_(4)^(+)/CD_(8)^(+)) levels,record the patients′adverse reactions during treatment Incidence rate.Results:After treatment,compared with the control group,the levels of AST,ALT and CMV-DNA,IFN-γ,TNF-αin the observation group were reduced,IL-18,IL-10,(CD_(4)^(+)/CD_(8)^(+)),and the NK′level was elevated,the negative time of observation group CMV-DNA is shorter and the difference was statistically significant(P<0.05);the adverse reaction between the two groups during treatment was not statistically significant(P>0.05).Conclusion:In patients with cytomegalovirus hepatitis,ganciclovir combined with reduced glutathione therapy under basic treatment conditions have a significant effect on improving liver function,promoting body immunity,and improving Th1/Th2 cytokine balance network system.The combined medication program does not increase the incidence of adverse drug reactions,and the medication is safe and reliable.

关 键 词：巨细胞病毒性肝炎 更昔洛韦 还原型谷胱甘肽 肝功能 免疫功能 

分 类 号：R575.1[医药卫生—消化系统]