利肝隆联合异甘草酸镁治疗自身免疫性肝炎患者疗效及其对血清趋化因子水平的影响

Liganlong and magnesium isoglycyrrhizate combination mitigates liver injury via inhibiting humoral immunity in patients with autoimmune hepatitis

目的分析应用利肝隆联合异甘草酸镁治疗自身免疫性肝炎(AIH)患者的疗效及其对血清免疫球蛋白和趋化因子-8(CF-8)、CF-2和CF-9水平的影响。方法2017年7月~2019年5月我院感染病科和消化内科收治的AIH患者122例,采用随机数字表法将其分对照组61例和观察组61例。在对照组,给予异甘草酸镁注射液治疗,观察组在对照组治疗的基础上给予利肝隆片治疗,两组均治疗3个月。采用ELISA法检测血清CF-8、CF-2和CF-9水平,采用免疫比浊法检测血清免疫球蛋白G(IgG)、IgM和IgA水平。结果在治疗结束时,观察组血清谷丙转氨酶(ALT)水平为(46.3±13.7)U/L,显著低于对照组[(82.5±14.2)U/L,P<0.05]和血清谷草转氨酶(AST)水平为(45.5±14.3)U/L,显著低于对照组[(66.7±16.8)U/L,P<0.05];血清CF-8水平为(10.6±2.1)pg/mL,显著低于对照组[(15.8±3.3)pg/mL,P<0.05],血清CF-2水平为(13.5±1.0)pg/mL,显著低于对照组[(19.0±1.3)pg/mL,P<0.05],血清CF-9水平为(12.1±1.7)pg/mL,显著低于对照组[(15.8±1.4)pg/mL,P<0.05];血清IgG水平为(1313.1±191.0)mg/L,显著低于对照组[(1816.4±311.6)mg/L,P<0.05],血清IgM水平为(506.2±151.3)mg/L,显著低于对照组[(814.1±225.1)mg/L,P<0.05],血清IgA水平为(509.1±128.6)mg/L,显著低于对照组[(749.7±231.9)mg/L,P<0.05];在治疗过程中,观察组不良反应发生率为18.0%,与对照组的4.9%比,差异无统计学意义(P>0.05)。结论应用利肝隆联合异甘草酸镁治疗自身免疫性肝炎患者可抑制机体亢进的体液免疫反应,降低CF-8、CF-2和CF-9水平,显著改善患者肝功能,而不会增加用药后不良反应。

Objective The aim of this study was to analyze Liganlong,a herbal conpound,and magnesium isoglycyrrhizate combination how to mitigates liver injury in patients with autoimmune hepatitis(AIH).Methods 122 patients with AIH were admitted to Department of Infectious Diseases and Gastroenterology in our hospital between July 2017 and May 2019,and were divided into control group and observation group by computer-generated randomized numbers,with 61 cases in each.The patients in the control group were treated by intravenous infusion of magnesium isoglycyrrhizinate and those in the observation group were treated with Liganlong tablets orally at the basis of medicine in the control group.The regimen in both groups lasted for 3 months.Serum chemotactic factor(CF)and immunoglobulin(Ig)levels were detected.Results At the end of treatment,serum alanine aminotransferase(ALT)level in the observation group was(46.3±13.7)U/L,significantly lower than[(82.5±14.2)U/L,P<0.05]and serum aspartate aminotransferase(AST)level was(45.5±14.3)U/L,significantly lower than[(66.7±16.8)U/L,P<0.05]in the control group;serum CF-8 level was(10.6±2.1)pg/mL,significantly lower than[(15.8±3.3)pg/mL,P<0.05],serum CF-2 level was(13.5±1.0)pg/mL,significantly lower than[(19.0±1.3)pg/mL,P<0.05],and serum CF-9 level was(12.1±1.7)pg/mL,significantly lower than[(15.8±1.4)pg/mL,P<0.05];serum IgG level was(1313.1±191.0)mg/L,significantly lower than[(1816.4±311.6)mg/L,P<0.05],serum IgM level was(506.2±151.3)mg/L,significantly lower than[(814.1±225.1)mg/L,P<0.05],and serum IgA level was(509.1±128.6)mg/L,significantly lower than[(749.7±231.9)mg/L,P<0.05]in the control;during the treatment,the incidence of side effects in the combination group was 18.0%,not significantly different as compared to 4.9%in the control group(P>0.05).Conclusion The steroid free treatment,e.g.Liganlong,a herbal medicine,and magnesium isoglycyrrhizinate combination,in patients with autoimmune hepatitis is a real viable option to obtain remission,that might be related to the inhibition of humoral immunity,reduction of serum CF-8,CF-9 and CF-2 levels and obviously improvement of liver functions.