注射用丁二磺酸腺苷蛋氨酸辅助治疗肝内胆汁淤积性乙型病毒性肝炎的效果

Effect of Adenine Methionine Butyldisulfonate for Injection in Adjuvant Treatment of Intrahepatic Cholestasis Hepatitis B

目的 研究注射用丁二磺酸腺苷蛋氨酸辅助治疗肝内胆汁淤积性乙型病毒性肝炎的效果。方法 选取2019年3月-2020年3月我院肝内胆汁淤积性乙型病毒性肝炎患者136例,按照随机数字表法分为常规组、联合组,各68例。常规组采用门冬氨酸钾镁、恩替卡韦治疗,联合组在常规组基础上采用注射用丁二磺酸腺苷蛋氨酸治疗。比较两组疗效、治疗前、治疗1个月后肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、碱性磷酸酶(ALP)]、凝血功能[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)]、肝纤维化指标[转化生长因子β1(TGF-β1)、结缔组织生长因子(CTGF)],分析治疗1个月后凝血功能与肝纤维化指标的相关性及不良反应发生率。结果 联合组总有效率97.06%高于常规组83.82%(P<0.05);治疗1个月后联合组ALT、AST、TBIL、ALP低于常规组(P<0.05);治疗1个月后联合组PT、APTT、TT短于常规组,FIB大于常规组(P<0.05);治疗1个月后联合组血清TGF-β1、CTGF水平低于常规组(P<0.05);经Pearson相关性分析,凝血功能与肝纤维化指标具有一定相关性(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 注射用丁二磺酸腺苷蛋氨酸辅助治疗肝内胆汁淤积性乙型病毒性肝炎疗效显著,能改善肝功能及凝血功能,预防肝纤维化形成,安全性高。

Objective To study the effect of adenosylmethionine succinate for injection in adjuvant treatment of intrahepatic cholestatic hepatitis B.Methods 136 patients with intrahepatic cholestatic hepatitis B in our hospital from March 2019 to March 2020 were randomly divided into routine group and combined group, with 68 cases in each group.The conventional group was treated with potassium magnesium aspartate and entecavir, and the combined group was treated with adenosylmethionine succinate for injection based on the conventional group.The curative effect, liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),alkaline phosphatase(ALP)],coagulation function[prothrombin time(PT),activated partial prothrombin time(APTT),thrombin time(TT),fibrinogen(FIB)were compared between the two groups before and after treatment.Results The total effective rate of the combined group was 97.06% higher than that of the conventional group(83.82%,P<0.05).After one month of treatment, ALT,AST,TBIL and ALP in combination group were lower than those in routine group(P<0.05).After one month of treatment, PT, APTT and TT in the combined group were shorter than those in the conventional group, while FIB was larger than that in the conventional group(P<0.05).After one month of treatment, the levels of serum TGF-β1 and CTGF in combined group were lower than those in routine group(P<0.05).Pearson correlation analysis showed that there was a certain correlation between coagulation function and liver fibrosis index(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ademetionine succinate for injection is effective in the adjuvant treatment of intrahepatic cholestatic hepatitis B,which can improve liver function and blood coagulation function, prevent the formation of liver fibrosis and has high safety.