拉米夫定联合大黄素抗肝纤维化作用的临床研究

Clinical study on the effect of combination therapy with lamivudine and emodin against hepatic fibrosis

目的 研究拉米夫定联合大黄素治疗HBV复制期不同肝病患者肝纤维化的价值。方法 采用RIA法和荧光定量PCR技术 ,分别检测 118例不同肝病患者拉米夫定联合大黄素治疗前和治疗 6个月后血清肝纤维化指标 (LN、HA、PⅢ、Ⅳ .C)和HBVDNA的含量 ,另 2 1例慢乙肝采用单一拉米夫定治疗 ,用同法检测其血清含量。结果 联合用药后各组HBVDNA含量明显下降 ,但LN、HA、PⅢ、Ⅳ .C在不同组别下降幅度不一 ,乙肝病毒携带者组t值分别为 2 .19、2 .4 0、2 .2 5、2 .88,慢性乙肝组为 3.77、3.18、3.71、4 .81,代偿性肝硬化组为 2 .5 3、4 .2 6、3.97、2 .5 2 ,失代偿性肝硬化组为 0 .2 7、0 .4 2、0 .5 5、0 .5 2 (P均 >0 .1)。单一拉米夫定治疗慢性乙肝组 ,抗肝纤维化能力小于联合用药组。结论 1、联合治疗可使乙肝病毒携带者、慢性乙肝、代偿性肝硬化患者血清LN、HA、PⅢ、Ⅳ .C含量显著下降。失代偿性肝硬化组血清LN、HA、PⅢ、Ⅳ .C含量无明显变化 ,但能阻止或延缓病变进程。 2、拉米夫定联合大黄素抗慢乙肝纤维化疗效明显优于单用拉米夫定。

Objective To investigate the effect of combination therapy with lamivudine and emodin on hepatic fibrosis in hepatopathes with hepatitis B virus. Methods 118 hepatopathes were treated with lamivudine and emodin for 6 monthes.The contents of LN?HA?PⅢ?Ⅳ.C and HBV DNA in serum before and after treatment were determined by RIA and PCR-Flourescence quantity respectively.The serum contents in 21 chronic hepatitis B patients who were treated by lamivudine were determined similarly. Results Contents of HBV DNA in each group significantly decreased after combination treatment with lamivudine and emodin.But the descent level of LN?HA?PⅢ?and Ⅳ.C were different.In HBVcarrier group?chronic hepatitis B group?compensated cirrhosis group and decompensated cirrhosis group,the t-value of LN?HA?PⅢ?Ⅳ.C was 2.19?2.40?2.25?2.88,3.77?3.18?3.71?4.81, 2.53?4.26?3.97?2.52 and 0.27?0.42?0.55?0.52 respectively.The effect of combination therapy against hepatic fibrosis was better than that of Lamivudine. Conclutions 1?The contents of LN?HA?PⅢ and Ⅳ.C could be significantly decreased with combination treatment in HBV carrier group?chronic hepatitis B group and compensated cirrhosis group. However,the contents in decompensated cirrhosis group were not obviously decreased(P>0.1),but the combination therapy could impede or postpone lesion developing. 2?The effect of combination therapy with lamivudine and emodin against hepatic fibrosis in chronic hepatitis B was better than that of lamivudine.