丹参酮IIA磺酸钠治疗晚期血吸虫病肝纤维化的效果观察

Clinical efficiency of tanshinone IIA-sulfonate in treatment of liver fibrosis of advanced schistosomiasis

目的观察丹参酮IIA磺酸钠注射液(STS)治疗晚期血吸虫病(晚血)肝纤维化的临床效果。方法观察对象分为对照组和治疗组,对照组进行常规保肝治疗14 d,治疗组在对照组同样治疗方法的基础上加用STS。2组患者分别在治前及治后第15 d进行门静脉内径测量、肝纤维化4项指标(PⅢP、CⅣ、HA、LN)及血清酶活性3项(ALT、AST、γGT)测定。所有患者血吸虫病胶体染料法(DDIA)、HBsAg均为阴性。结果治疗后,2组患者的门静脉内径及血清酶各项指标的阳性数均有所下降,但差异均无统计学意义。治疗组纤维化指标阳性数均有所下降,但仅CⅣ差异有统计学意义(χ2=4.303,P=0.037);对照组则有升有降。以测量指标数值的降低判断改善情况,治疗组肝纤维化指标中有3项(PⅢP、CⅣ、HA)达到改善,其中2项(PⅢP、HA)达到明显改善。血清酶指标无改善。结论STS有较好的抗肝纤维化作用。

Objective To evaluate the clinical efficiency of tanshinone IIAsulfonate （STS） in the treatment of liver fibrosis of advanced schistosomiasis. Methods A total of 73 advanced schistosomiasis patients were selected into a treatment group and 55 cases of advanced schistosomiasis were selected into a control group, and dipstick dye immunoassay assay （DDIA） for schisto somiasis and HBsAg of all the patients were negative. The patients in the treatment group received STS for 14 days, and all the pa tients in both groups received the conventional liverprotecting treatment for 14 days. All the patients in both groups received the measurements of portal vein, 4 indicators of liver fibrosis （P HI P, C IV, HA, LN）, and 3 indicators of serum enzyme activities （ALT, AST, /GT）. Results After the treatments, the inside diameters of the portal vein and the degrees of the positive results of indicators of serum enzyme activities of all the patients of both groups decreased, but there were no statistically significant differ ences compared with those before the treatment. In the treatment group, the degrees of the positive results of indicators of liver fi brosis decreased somewhat, but there were no statistically significant differences compared with those before the treatment except C IV. In the control group, the degrees of the positive results of indicators of liver fibrosis fluctuated. In the treatment group, the indi cator of liver fibrosis, C IV improved and the 2 indicators of liver fibrosis, P HI P and HA improved significantly, but the indicators of serum enzyme activities did not improve. Conclusion STS is effective in the treatment of liver fibrosis of advanced schistosomi