替诺福韦酯联合虫草胶囊治疗慢性乙型肝炎肝硬化患者血清TGFβ1、ET-1和CTGF水平变化  

Changes of serum TGFβ1,ET-1 and CTGF levels in patients with chronic hepatitis B cirrhosis treated with tenofovir dipivoxil and cordyceps capsules

作　　者：郝雁雁 王威雪 王瑞萍 何飞 Hao Yan-yan;Wang Wei-xue;Wang Rui-ping;He Fei(Department of Hepatology,Handan Infectious Disease Hospital,Handan 056002,China;Department of Surgery,the Second filiated Hospital of Liaoning Urdvershy of Traditioncil Chinese Medicine,Shenyang 11003,China)

机构地区：[1]邯郸市传染病医院肝病科,邯郸056002 [2]辽宁中医药大学附属第二医院外科,沈阳110034

出　　处：《湖南师范大学学报（医学版）》2022年第1期134-137,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨替诺福韦酯联合虫草胶囊治疗慢性乙型肝炎肝硬化患者血清转化生长因子(TGFβ1)、内皮素-1(ET-1)和结缔组织生长因子(CTGF)水平变化。方法:2017年3月~2018年3月我院收治的84例慢性乙型肝炎肝硬化患者,通过随机数字表法分为观察组与对照组,每组各42例患者,两组均接受替诺福韦酯治疗,观察组患者再此基础上加用虫草胶囊,两组均持续治疗6个月,采用彩色多普勒测定门静脉内径、脾静脉内径、脾脏厚度,使用全自动生化分析仪检测血清总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)水平,采用放射免疫法检测血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(CIV)、Ⅲ型前胶原(PIIIP)水平,采用酶联免疫吸附法测定血清转化生长因子-β1(TGF-β1)、内皮素(ET-1)和结缔组织生长因子(CTGF)水平。结果:在治疗6个月后,观察组HBV-DNA转阴率、HBeAg转阴率分别为90.5%和47.5%,显著高于对照组【73.8%和26.9%,P<0.05】;观察组门静脉内径、脾静脉内径、脾脏厚度分别为(10.1±1.0)mm、(9.2±1.1)mm和(36.2±3.7)mm显著小于对照组【(11.9±1.3)mm、(10.6±2.8)mm和(43.8±5.1)mm,P<0.05】;观察组肝功能指标ALT、AST、TBIL水平分别为(39.4±6.1)U/L、(34.7±5.1)U/L和(15.6±3.7)μmol/L显著低于对照组【(57.2±8.5)U/L、(51.5±7.9)U/L和(19.6±3.0)μmol/L,P<0.05】;观察组ALB水平为(45.8±4.9)g/L显著高于对照组【(41.2±3.9)U/L,P<0.05】;观察组血清TGFβ1、ET-1和CTGF水平分别为(167.6±19.8)pg/mL、(71.2±10.8)ng/L和(22.2±2.1)μg/L显著低于对照组【(197.9±18.5)pg/mL、(89.7±11.5)ng/L和(25.8±2.6)μg/L,P<0.05】;观察组肝纤维化指标指标HA、LN、Ⅳ-C、PC-Ⅲ水平分别为(91.1±16.6)ng/mL、(136.6±29.4)ng/mL、(169.3±43.6)ng/mL和(119.7±23.4)ng/mL显著低于对照组【(127.6±20.0)ng/mL、(169.9±32.5)ng/mL、(214.8±59.4)ng/mL和(140.0±28.5)ng/mL,P<0.05】。结论:应用替诺福韦酯联合�Objective To explore the changes in levels of serum transforming growth factor β1(TGFβ1),endothelin-1(ET-1) and connective tissue growth factor (CTGF) in patients with chronic hepatitis B cirrhosis treated with tenofovir dipivoxil and cordyceps capsules.Methods A total of 84 patients with chronic hepatitis B cirrhosis admitted to the hospital were enrolled between March 2017 and March 2018.They were divided into observation group and control group by random number table method,42 cases in each group.The patients in both groups were treated with tenofovir dipivoxil.On this basis,observation group was treated with cordyceps capsules.Both groups were continuously treated for 6 months.The diameters of portal vein and spleen vein,and spleen thickness were measured by color Doppler.The levels of serum total bilirubin (TBIL),alanine aminotransferase (ALT),aspartate aminotransferase (AST) and albumin (ALB) were detected by full-automatic biochemical analyzer.The levels of serum hyaluronan (HA),laminin (LN),type-Ⅳ collagen (CIV) and type Ⅲ procollagen (PIIIP) were detected by radioimmunoassay.The levels of serum transforming growth factor-β1(TGF-β1),endothelin (ET-1) and connective tissue growth factor (CTGF) were detected by enzyme linked immunosorbent assay.Results After 6 months of treatment,negative conversion ratios of HBV-DNA and HBeAg in observation group were 90.48% and 47.52%,significantly higher than those in control group [73.81%,26.91%,P<0.05].The portal vein diameter,spleen vein diameter and spleen thickness in observation group were (10.1±1.0) mm,(9.2±1.1) mm and (36.2±3.7) mm,significantly shorter than those in control group [(11.9±1.3) mm,(10.6±2.8) mm,(43.8±5.1) mm,P<0.05].The levels of ALT,AST and TBIL in observation group were (39.4±6.1) U/L,(34.7±5.1) U/L and (15.6±3.7) μmol/L,lower than those in control group [(57.2±8.5) U/L,(51.5±7.9) U/L,(19.6±3.0) μmol/L,P<0.05].ALB level in observation group was significantly higher than that in control group [(45.8±4.9) g/L vs (41.2±3.9) U

关 键 词：慢性乙型肝炎 肝硬化 替诺福韦酯 虫草胶囊 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]