复方丹参注射液联合替诺福韦酯治疗对乙肝肝硬化失代偿期肝脏硬度及血清Th1/Th2型细胞因子表达的影响  

Effect of Compound Danshen Injection(复方丹参注射液) Combined with Tenofovir Dipivoxil on Liver Stiffness and Serum Th1/Th2 Cytokine Expression in Patients with Decompensated Hepatitis B Cirrhosis

作　　者：侯艾林[1] 贺汉军 唐剑萍[1] HOU Ailin;HE Hanjun;TANG Jianping(The First People's Hospital of Guangyuan,Guangyuan 628017,Sichuan,China)

机构地区：[1]广元市第一人民医院,四川广元628017

出　　处：《中华中医药学刊》2022年第11期69-72,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：中华医学会临床医学科研专项基金(192615935632)。

摘　　要：目的 探讨复方丹参注射液联合替诺福韦酯治疗对乙肝肝硬化失代偿期患者肝脏硬度及血清Th1/Th2型细胞因子表达的影响。方法 选取2017年6月—2020年8月医院乙肝肝硬化失代偿期患者92例采取前瞻性随机对照研究,以随机数字表分为联合组和对照组,每组46例。对照组给予替诺福韦酯,联合组给予复方丹参注射液联合替诺福韦酯,均治疗6个月。对比两组疗效与治疗前、治疗后血清肝功能指标[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]、肝纤维化指标[Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)、透明质酸(HA)]、Th1/Th2型细胞因子[白细胞介素-6(IL-6)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)、白细胞介素-18(IL-18)]表达、超声指标(脾脏厚度、脾静脉内径、门静脉内径)水平、Fibroscan检测的肝脏硬度值。结果 联合组治疗6个月后总有效率高于对照组(P<0.05);联合组治疗6个月后血清TBIL、ALT、AST水平低于对照组(P<0.05);联合组治疗6个月后血清Ⅳ-C、LN、HA水平低于对照组(P<0.05);联合组治疗6个月后血清IL-6、IL-4水平低于对照组,血清IFN-γ、IL-18水平高于对照组(P<0.05);联合组治疗6个月后脾脏厚度、脾静脉内径、门静脉内径低于对照组(P<0.05);联合组治疗6个月后肝脏硬度值低于对照组(P<0.05)。结论 复方丹参注射液联合替诺福韦酯治疗乙肝肝硬化失代偿期患者,可调节Th1/Th2型细胞因子表达,改善肝功能及肝纤维化,降低肝脏硬度,疗效显著。Objective To investigate the effect of Compound Danshen Injection(复方丹参注射液)combined with tenofovir dipivoxil on the liver stiffness and serum Th1/Th2 cytokine expression in patients with decompensated hepatitis B cirrhosis.Methods A prospective randomized controlled study of 92 patients with decompensated hepatitis B cirrhosis in the hospital from June 2017 to August 2020 was selected.The patients were divided into a combined group(46 cases)and a control group(46 cases)with a random number table.The control group was given tenofovir dipivoxil and the combined group was given Compound Danshen Injection combined with tenofovir dipivoxil for 6 months.The efficacy,the serum liver function indexes[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],liver fibrosis indexes[type IV collagen(Ⅳ-C),laminin(LN),hyaluronic acid(HA)],the expressions of Th1/Th2 cytokines[interleukin-6(IL-6),interleukin-4(IL-4),interferon-γ(IFN-γ),interleukin-18(IL-18)],ultrasound indexes(spleen thickness,splenic vein inner diameter,portal vein inner diameter)level were compared and the liver hardness value detected by Fibroscan before treatment and after 6 months of treatment of the two groups.Results The total effective rate of the combined group after 6 months of treatment was higher than that of the control group(P<0.05).The levels of serum TBIL,ALT and AST in the combined group was lower than that in the control group after 6 months of treatment(P<0.05).The levels of serum IV-C,LN and HA in the combined group were lower than those in the control group after 6 months of treatment(P<0.05).After 6 months of treatment in the combined group,the serum levels of IL-6 and IL-4 were lower than those of the control group,and the serum levels of IFN-γand IL-18 were higher than those of the control group(P<0.05).The spleen thickness,inner diameter of splenic vein and inner diameter of portal vein were lower in the combined group after 6 months of treatment(P<0.05).The liver stiffness value of the combi

关 键 词：复方丹参注射液 替诺福韦酯 乙肝肝硬化失代偿期 肝脏硬度 TH1/TH2型细胞因子 

分 类 号：R269.573.1[医药卫生—中西医结合]