拉米夫定联合阿德福韦酯治疗对失代偿期乙型肝炎肝硬化患者肝纤维化指标及血清炎性因子的影响

Effect of the Hepatic Fibrosis Index and Serum Inflammatory Factors in Patients with Decompensated Hepatitis B Cirrhosis Treated with Lamivudine and Adefovir Dipivoxil

目的:探讨拉米夫定联合阿德福韦酯对失代偿期乙型肝炎肝硬化患者肝纤维化指标及血清炎性因子的影响,分析其可能作用机制。方法:选择荆州市第二人民医院2016年1-12月收治的失代偿期乙型肝炎肝硬化患者128例为研究对象,根据入院单双号随机分为观察组和对照组,各64例。对照组给予阿德福韦酯治疗,观察组给予拉米夫定联合阿德福韦酯治疗,治疗1年后,比较两组肝脏纤维化、肝功能、炎性因子等指标。结果:观察组血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)含量均明显低于对照组(t=15.759、10.558、14.751,P<0.01);血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)含量均明显低于对照组(t=13.957、14.833、20.983,P<0.01);血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)含量均明显低于对照组(t=10.933、12.394、8.360,P<0.05)。结论:拉米夫定联合阿德福韦酯治疗有助于阻止失代偿期乙型肝炎肝硬化患者肝纤维化进展,改善肝功能,可能与降低血清炎性因子表达水平等因素有关。

Objective:To investigate the effect of the hepatic fibrosis index and serum inflammatory factors in patients with decompensated hepatitis B cirrhosis treated with Lamivudine and Adefovir Dipivoxil,both to analyze its possible mechanism.Method:128 patients with decompensated hepatitis B cirrhosis treated in the Second People’s Hospital of Jingzhou were selected from January 2016 to December 2016.According to admission single-double numbers,patients were randomly divided into the observation group and the control group,64 cases in each group.In the control group,patients were treated with Adefovir Dipivoxil,in the observation group,patients were treated with Lamivudine plus Adefovir Dipivoxil.After one year of treatment,the indexes of liver fibrosis,liver function and inflammatory factors were compared between the two groups.Result:The levels of serum HA,LN and PCⅢin the observation group were significantly lower than those in the control group(t=15.759,10.558,14.751,P<0.01).Serum levels of ALT,AST and TBil in the observation group were significantly lower than those of the control group(t=13.957,14.833,20.983,P<0.01).The contents of serum IL-6,hs-CRP and TNF-αin the observation group were significantly lower than those of the control group(t=10.933,12.394,8.360,P<0.05).Conclusion:Lamivudine combined with Adefovir Dipivoxil treatment can help to prevent the progression of hepatic fibrosis in patients with decompensated hepatitis B cirrhosis and improve liver function,which may be related to factors such as reducing the expression level of serum inflammatory factors.