索非布韦/达克拉韦治疗CHC患者血清血管性血友病因子和可溶性血管黏附因子1水平变化  

Serumv on Willebrand factor and soluble vascular cell adhesion molecule-1 level changes in patients with hepatitis C viral infection

作　　者：朱中华 胡均贤[2] 李炎[3] Zhu Zhonghua;Hu Junxian;Li Yan(Clinical Laboratory,Second Affiliated Hospital,Hubei Institute of Technology,Huanggang 435100,Hubei Province,China)

机构地区：[1]湖北理工学院第二附属医院/大冶市人民医院检验科,湖北省黄冈市435100 [2]黄冈市中心医院神经外科 [3]黄冈市中心医院检验科

出　　处：《实用肝脏病杂志》2024年第6期836-839,共4页Journal of Practical Hepatology

基　　金：湖北省黄冈市科学技术局科研计划项目[编号:黄科字(2017)5号]。

摘　　要：目的本研究旨在探讨直接抗病毒药物治疗的慢性丙型肝炎(CHC)患者的疗效及其对血清细胞因子水平的影响。方法2020年6月~2022年12月我院诊治的38例CHC患者和38例丙型肝炎肝硬化患者,均接受索非布韦(SOF)、盐酸达克拉韦(DCV)和利巴韦林三联疗法治疗12周。采用RT-PCR法检测血清HCV RNA载量,采用ELISA法检测血清血管性血友病因子(vWF)、可溶性血管黏附因子1(sVCAM-1)和白细胞介素-6(IL-6)水平。结果本组丙型肝炎肝硬化患者快速病毒学应答、治疗结束病毒学应答和持续病毒学应答率分别为81.5%、89.5%和97.4%,与CHC组的89.5%、92.1%和100.0%比,无显著性差异(P>0.05);在治疗结束时,肝硬化组外周血白细胞和血小板计数分别为(4.7±0.9)×10^(9)/L和(139.5±42.1)×10^(9)/L,显著低于CHC组【分别为(6.8±2.2)×10^(9)/L和(275.6±65.3)×10^(9)/L,P<0.05】,而基于4因子的肝纤维化指数(FIB4)和天冬氨酸氨基转移酶/血小板计数指数(APRI)评分分别为(2.8±1.6)和(0.6±0.3),显著高于CHC组【分别为(0.7±0.9)和(0.2±0.1),P<0.05】;肝硬化组血清vWF和sVCAM-1水平分别(134.3±44.3)ng/mL和(36.6±14.9)ng/mL,显著高于CHC组【分别为(103.9±33.0)ng/mL和(18.7±8.9)ng/mL,P<0.05】。结论应用DAAs治疗HCV感染患者可获得良好的抗病毒疗效,且能有效改善血管内皮功能,其临床意义还有待进一步探讨。Objective This study was aimed to investigate serum von Willebrand factor(vWF)and soluble vascular cell adhesion molecule-1(VACM-1)level changes in patients with hepatitis C viral infection.Methods 38 patients with chronic hepatitis C(CHC)and 38 patients with hepatitis C-induced liver cirrhosis(LC)were enrolled in our hospital between June 2020 and December 2022,and all received sofosbuvir,daclatasvir and ribavirin combination therapy for 12 weeks.Serum HCV RNA loads were detected by RT-PCR,and serum vWF,VACM-1 and interleukin-6 levels were assayed by ELISA.Results The rapid virological response,end treatment of virological response and sustained virological response rates in patient with LC were 81.5%,89.5%and 97.4%,not significantly different as compared to 89.5%,92.1%and 100.0%in patients with CHC(P>0.05);at the end of antiviral therapy,the white blood cell count and platelet count in patients with LC were(4.7±0.9)×10^(9)/L and(139.5±42.1)×10^(9)/L,much lower than[(6.8±2.2)×10^(9)/L and(275.6±65.3)×10^(9)/L,P<0.05],while the FIB-4 and APRI scores were(2.8±1.6)and(0.6±0.3),much higher than[(0.7±0.9)and(0.2±0.1),respectively,P<0.05]in patients with CHC;serum vWF and sVCAM-1 levels in patients with LC were(134.3±44.3)ng/mL and(36.6±14.9)ng/mL,significantly higher than[(103.9±33.0)ng/mL and(18.7±8.9)ng/mL,respectively,P<0.05]in patients with CHC.Conclusion The application of DAAs in treating patients with HCV infection is efficacious,which might improve endothelial function,and needs further study.

关 键 词：肝硬化 慢性丙型肝炎 直接抗病毒药物 血管性血液病因子 可溶性血管细胞粘附分子-1 治疗 

分 类 号：R512.63[医药卫生—内科学]