联合驱铜治疗对WD患者肝脏剪切波弹力成像与肝纤维化肝功能检测指标的影响  

Effects of combined copper displacement therapy on liver shear wave elastography,liver fibrosis and liver function in WD patients

作　　者：刘娅 胡文彬 严彦 苏贝晴 李瑶瑶 蒋雨晨 吴君霞 喻绪恩 王训 胡纪源 韩咏竹 杨任民 LIU Ya;HU Wenbin;YAN Yan;SU Beiqing;LI Yaoyao;JIANG Yuchen;WU Junxia;YU Xu’en;WANG Xun;HU Jiyuan;HAN Yongzhu;YANG Renmin(Graduate School,Anhui University of Traditional Chinese Medicine,Hefei 230038,China;Affiliated Hospital of the Institute of Neurology,Anhui University of Traditional Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230038 [2]安徽中医药大学神经病学研究所附属医院神经内科,安徽合肥230061 [3]安徽中医药大学神经病学研究所附属医院彩超室,安徽合肥230061 [4]安徽中医药大学神经病学研究所附属医院检验科,安徽合肥230061

出　　处：《安徽医学》2025年第1期77-82,共6页Anhui Medical Journal

基　　金：安徽省高校科研重大项目(编号:2024AH040140);安徽中医药大学自然科学研究重大项目(编号:2021sfylc01)。

摘　　要：目的 探讨联合驱铜治疗对Wilson病(WD)患者的肝脏剪切波弹力成像与肝纤维化、肝功能检测指标的影响。方法 回顾性分析2021年1月至2023年12月于安徽中医药大学神经病学研究所附属医院住院治疗的87例住院WD患者的临床资料,根据其治疗方案不同进行分组,使用金属络合剂等西药联合中药肝豆片驱铜治疗的患者作为联合治疗组(n=45),单纯使用金属络合剂等西药驱铜治疗的患者作为西医治疗组(n=42);观察两组患者临床疗效,记录两组患者治疗前、后的肝脏剪切波弹力成像检测值(pSWE)、层黏蛋白(LN)、Ⅲ型前胶原肽(P-ⅢNP)及Ⅳ型胶原蛋白(C-Ⅳ)等肝纤维化指标,总胆汁酸(TBA)、清蛋白(ALB)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)等肝功能指标水平。结果 两组患者治疗前肝脏剪切波弹力成像检测值与肝纤维化、肝功能检验指标比较,差异均无统计学意义(P>0.05);驱铜治疗后,两组患者治疗前与治疗后剪切波弹力成像测值、C-Ⅳ及TBA及差值比较,差异有统计学意义(P<0.05)。WD患者肝脏剪切波弹力成像测值与IV型胶原蛋白及总胆汁酸均呈正相关(P<0.05)。结论 驱铜治疗可改善WD患者的肝脏损害,并且联合治疗组疗效优于西医治疗组,更加有利于患者的康复与生活质量的提高。Objective To examine the effects of combined copper displacement therapy on liver shear wave elastography,liver fibrosis and liver function in patients diagnosed with Wilson’s disease(WD).Methods The clinical data of 87 inpatient WD patients admitted the Affili-ated Hospital of the Institute of Neurology,Anhui University of Traditional Chinese Medicine during January 2021 to December 2023 were ret-rospectively analyzed.Patients were divided into groups according to their different treatment regimens.Those undergoing Western medicines,such as metal complex agents,combined with traditional Chinese medicine Gantou tablet for copper removal,comprised the combined treat-ment group(n=45).Conversely,patients treated with Western medicine,such as metal complex agents,constituted the Western medicine treat-ment group(n=42).The clinical signs of the two groups were observed,including the point-shear wave elastography(pSWE),liver fibrosis in-dexes such as laminin(LN),procollagen-ⅢN-terminal peptidase(P-ⅢNP)and collagenⅣ(C-Ⅳ),total bile acid(TBA),albumin(ALB),as-partate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin(TBIL),were recorded in the two groups before and after treatment and other liver function indicators.Results There were no significant differences in the values of liver shear wave elastography,liver fi-brosis and liver function between the two groups before treatment(P>0.05).After copper displacement treatment,the measured value of shear wave elastic imaging,typeⅣcollagen and total bile acid and the difference between the two groups were compared before and after treatment,and the difference was statistically significant(P<0.05).There was a positive correlation between liver shear wave elastography and typeⅣcol-lagen and total bile acid in WD patients(P<0.05).Conclusion Copper displacement therapy can improve the liver damage of WD patients,and the combined treatment group demonstrates superior outcomes compared to the Western medicine treatment group,which is more conduciv

关 键 词：WILSON病 剪切波弹力成像 肝纤维化 肝功能 

分 类 号：R73[医药卫生—肿瘤]