恩替卡韦联合亮菌口服液治疗乙型肝炎肝硬化的疗效观察及对肝功能和血清细胞因子的影响

Efficacy of entecavir combined with Armillariella oral solution in the treatment of hepatitis B-related liver cirrhosis and its effect on liver function and serum cytokines

目的探讨恩替卡韦联合亮菌口服液治疗乙型肝炎肝硬化的疗效及对肝功能和血清细胞因子的影响。方法研究对象为2015年1月一2017年I月海南医学院第二附属医院住院或门诊收治的126例乙型肝炎肝硬化患者。随机分为观察组和对照组5=63)。观察组采用恩替卡韦联合亮菌口服液治疗,对照组采用恩替卡韦治疗。比较2组患者临床疗效、肝功能、肝纤维化指标、病毒阴转率、Child-Pugh积分、血清细胞因子含量、不良反应情况。结果观察组的总有效率(92.1%)显著高于对照组(76.2%)(P<0.05)。观察组总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均显著低于对照组,白蛋白(ALB)显著高于对照组(P<0.05)。观察组透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)及Ⅳ型胶原(Ⅳ-C)水平均显著低于对照组(P<0.05)。观察组门静脉内径、脾静脉内径、脾厚度均显著低于对照组(P<0.05)。观察组HBV-DNA阴转率显著高于对照组,Child-Pugh积分显著低于对照组(P<0.05)。观察组白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均显著低于对照组(P<0.05).2组均未发生任何明显不良反应。结论恩替卡韦联合亮菌口服液可有效抑制乙型肝炎肝硬化患者肝功能,延缓肝纤维化.降低血清炎性因子。

Objective To investigate the efficacy of entecavir combined with Armillariella oral solution in the treatment of hepatitis B-related liver cirrhosis and its effect on liver function and serum cytokines. Methods A total of 126 patients with hepatitis B-related liver cirrhosis from January 2015 to January 2017 were studied. All patients were randomly divided into observation group and control group (n=63 each). The observation group was treated with entecavir combined with leucella oral liquid and the control group was treated with entecavir alone. The clinical efficacy, liver function , liver fibrosis index, Child-Pugh score, serum cytokines and adverse reactions were compared between the two groups. Results The totcil effective rate of the observation group (92. 1%) was significantly higher than that of the control group (76. 2%)(P <0. 05). Compared with the control group, the levels of total bilirubin (TBIL), alanine aminotransferase (ALT) and glutamic oxaloacetic transaminase (AST) in lhe observation group were significantly lower, while the level of albumin (ALB) was significantly higher (P <0.05). Compared with the control group, the levels of hyaluronidase (HA), laminin (LN), procollagen III (PC III ) and collagen IV in the observation group were significantly lower (P<0.05 ). Compared with the control group, portal vein diameter, splenic vein diameter and thickness of spleen in the observation group were significantly lower (P<0.05 ). The negative conversion rate of HBV-DNA in the observation group was significantly higher than that in lhe control group, while Child-Pugh score in the observation group was significantly lower than that in the control group (P <0. 05 ). The levels of interleukin-1β(IL-1β), interleukin-6 (IL-6) and interleukin-8 (IL-8 ) in the observation group were significantly higher than those in the control group (P <0. 05). No significant adverse reactions were observed in both groups. Conclusions Entecavir combined with Arnullariella oral solution can effectively improve liver function, delay liver fibrosis and reduce serum inflammatory factors in patients with hepatitis B-related liver cirrhosis.