恩替卡韦联合苦黄注射液对ALT<2×ULN的HBeAg阴性慢性乙型肝炎患者凝血-纤溶功能、免疫炎症及肝脏硬度的影响

Effects of entecavir combined with Kuhuang injection on blood coagulation-fibrinolytic function, immune inflammation and liver stiffness in patients with HBeAg-negative chronic hepatitis B with ALT<2×ULN

目的观察恩替卡韦联合苦黄注射液对丙氨酸氨基转移酶(ALT)<2×正常值上限(ULN)的HBeAg阴性慢性乙型肝炎(CHB)患者凝血-纤溶功能、免疫炎症及肝脏硬度的影响。方法将98例ALT<2×ULN的HBeAg阴性CHB患者随机分为观察组50例和对照组48例,对照组给予恩替卡韦治疗,观察组在对照组治疗基础上给予苦黄注射液静滴治疗(每4周治疗1次,每次连续治疗2周,共治疗6次)。治疗24周后,比较2组肝功能指标、凝血-纤溶指标、免疫炎症指标、HBV DNA定量、HBsAg定量与肝脏硬度检测值(LSM)变化情况。结果 2组治疗后ALT、AST、GGT、TBil、纤维蛋白原(FIB)和D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)水平及国际化标准比值(INR)、中性粒细胞计数(NEU)、中性粒细胞与淋巴细胞比值(NLR)、HBV DNA定量、HBsAg定量、LSM均显著降低(P均<0.05),凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)均显著缩短(P均<0.05),淋巴细胞计数(LYM)显著升高,观察组治疗后以上指标改善情况均显著优于对照组(P均<0.05)。结论恩替卡韦联合苦黄注射液可显著改善ALT<2×ULN的HBeAg阴性CHB患者的肝功能,可明显调节凝血-纤溶功能和免疫炎症失衡,从而有利于减轻肝脏硬度和纤维化。

Objective It is to observe the effect of entecavir combined with Kuhuang injection on blood coagulation-fibrinolysis function, immune inflammation and liver stiffness of patients with HBeAg-negative chronic hepatitis B (CHB) with alanine aminotransferase (ALT)<2×normal upper limit (ULN). Methods Ninety-eight patients with HBeAg-negative CHB with ALT<2×ULN were randomly divided into observation group ( n =50) and control group ( n =48). The control group was treated with entecavir. The observation group was given intravenous infusion of Kuhuang injection on the basis of the control group (the treatment was performed once every 4 weeks, and each treatment was continued for 2 weeks for a total of 6 treatments). After 24 weeks of treatment, the changes of liver function index, coagulation-fibrinolysis index, immune inflammation index, HBV DNA quantification, HBsAg quantification and liver stiffness test value (LSM) were compared between the two groups. Results The levels of ALT, AST, GGT, TBil, fibrinogen (FIB), D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP) and international normalized ratio (INR), neutrophil count (NEU), neutrophil to lymphocyte ratio (NLR), HBV DNA quantification, HBsAg quantification, LSM were significantly decreased ( P <0.05), thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT) were significantly shortened ( P <0.05), lymphocyte count (LYM) was significantly increased ( P <0.05) in the two groups, and the improvement of the above indicators in the observation group was significantly better than that of the control group( P <0.05). Conclusion Entecavir combined with Kuhuang injection can significantly improve the liver function, regulate the coagulation-fibrinolysis function and immune inflammation imbalance in HBeAg-negative CHB patients with ALT<2×ULN, wit is beneficial to reduce liver stiffness and relieve fibrosis.