慢性乙型肝炎患者抗病毒治疗后肝纤维化动态变化的定性评估

Qualitative evaluation of dynamic changes of liver fibrosis in patients with chronic hepatitis B after antiviral therapy

目的定性评估慢性乙型肝炎患者抗病毒治疗后肝纤维化的动态变化。方法选取2017年1月至2017年12月于松岗人民医院接受治疗的慢性乙型肝炎患者112例为研究对象,采用随机数字表法分为观察组和对照组,每组56例。观察组患者采用安络化纤丸联合α-干扰素治疗,对照组患者仅采用α-干扰素治疗,观察两组患者临床症状(肝区痛、腹胀及肝肿大)、肝纤维化指标[(透明质酸酶(hyaluronidase,HA)、层粘连蛋白(laminin,LN)及C3氨基端肽(C3 amino terminal peptide,P3P)]及肝功能指标(ALT、TBil和γ球蛋白)的差异。结果治疗后,观察组患者肝区痛、腹胀及肝肿大的改善均显著优于对照组,血清肝纤维化指标(HA、LN和P3P)和肝功能指标(ALT、TBil和γ球蛋白)均显著低于对照组,差异有统计学意义(P <0.05)。治疗后,观察组患者的HBeAg阴转率、HBeAg血清学转换率和HBV DNA低于检测下限率分别为50.0%、45.6%和60.9%,对照组分别为26.0%、21.6%和37.9%,差异有统计学意义(χ~2值分别为6.380、6.821、6.038,P值分别为0.012、0.009、0.014)。结论慢性乙型肝炎患者采用安络化纤丸联合α-干扰素治疗,可显著降低血清肝纤维化指标,改善患者肝功能及临床指征,值得临床推广。

Objective To evaluate the dynamic changes of liver fibrosis in patients with chronic hepatitis B after antiviral therapy qualitatively.Methods Total of 112 cases with chronic hepatitis B in People’s Hospital of Songgang from January 2017 to December 2017 were selected and divided into observation group and control group according to random digital table method,56 cases in each group.Patients in observation group were treated with Anluo Hua Xian pill combined with alpha interferon,patients in control group were treated with alpha interferon only.The clinical symptoms(liver pain,abdominal distention and hepatomegaly),hepatic fibrosis indexes [hyaluronidase(HA),laminin(LN),C3 amino terminal peptide(P3P)] and liver function indexes(ALT,TBil and γ-globulin)were observed.Results After treatment,the improvement of liver pain,abdominal distension and hepatomegaly of patients in observation group were significantly better than those in control group,and the indexes of liver fibrosis(HA,LN and P3P)and liver function(ALT,TBil and γ globulin)were significantly lower than those in control group.The differences were statistically significant(P<0.05).After treatment,the negative conversion rate of HBeAg,the conversion rate of HBeAg and the rate of HBV DNA below the detection limit were 50.0%,45.6% and 60.9% in observation group,and 26.0%,21.6% and 37.9% in control group,respectively,the differences were statistically significant(χ^2=6.380,6.821,6.038;P = 0.012,0.009,0.014).Conclusions Anluo Hua Xian pill combined with alpha interferon can significantly reduce the serum hepatic fibrosis indexes,improve the liver function and clinical indications of patients with chronic hepatitis B,which is worthy of popularizing in clinical practice.