甘草酸二铵联合恩替卡韦对慢性乙型肝炎合并肝硬化患者肝纤维化指标及氧化应激指标的影响

Effects of diammonium glycyrrhizinate combined with entecavir on liver fibrosis and oxidative stress in patients with chronic hepatitis B and cirrhosis

目的探讨甘草酸二铵联合恩替卡韦对慢性乙型肝炎合并肝硬化患者肝纤维化指标及氧化应激指标的影响。方法从2017年1月~2018年5月深圳市龙岗中心医院感染科收治的慢性乙型肝炎合并肝硬化患者中选取80例进行研究,随机分为对照组与观察组各40例,对照组采用恩替卡韦治疗,观察组采用甘草酸二铵联合恩替卡韦治疗,对两组治疗效果、肝纤维化指标及氧化应激指标进行观察。结果观察组治疗总有效率为95.00%,较对照组75.00%高,差异有统计学意义(P<0.05);两组治疗前透明质酸(HA)、层粘连蛋白(LN)、IV型胶原(IV-C)比较,差异无统计学意义(P>0.05),观察组治疗后上述肝纤维化指标明显优于对照组,差异有统计学意义(P<0.05);两组治疗前丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)比较,差异无统计学意义(P>0.05),观察组治疗后上述氧化应激指标与对照组比较,差异有统计学意义(P<0.05)。结论甘草酸二铵联合恩替卡韦治疗慢性乙型肝炎合并肝硬化效果满意,可缓解肝纤维化状态,调节氧化应激水平,值得推广。

Objective To investigate the effects of diammonium glycyrrhizinate combined with entecavir on liver fibrosis and oxidative stress in patients with chronic hepatitis B and cirrhosis.Methods From January 2017 to May 2018,80 cases with chronic hepatitis B and cirrhosis admitted in department of infection of Longgang central hospital of Shenzhen were selected,and were randomly divided into the control group and the observation group,with 40 cases in each group.The control group was treated with entecavir,and the observation group was treated with diammonium glycyrrhizinate combined with entecavir.The therapeutic effects,liver fibrosis markers and oxidative stress indicators were observed and compared between the two groups.Results The total effective rate of the observation group was 95.00%,which was higher than that of the control group(75.00%),and the difference was statistically significant(P<0.05).The hyaluronic acid(HA),laminin(LN)and typeⅣcollagen(Ⅳ-C)between the two groups before treatment showed no statistically significance(P>0.05).After treatment,the liver fibrosis indicators in the observation group were significantly lower than those in the control group,and the difference were statistically significant(P<0.05).The malondialdehyde(MDA),superoxide dismutase(SOD)and nitric oxide(NO)between the two groups before treatment showed no statistically significance(P>0.05).After treatment,the oxidative stress indicators in the observation group were significantly better than those in the control group,and the difference were statistically significant(P<0.05).Conclusion Diammonium glycyrrhizinate combined with entecavir is effective in the treatment of chronic hepatitis B with cirrhosis,can alleviate the state of liver fibrosis and regulate the level of oxidative stress,worth of promoting.