苦参素对慢性乙型肝炎患者血清TGF-β1、TNF-α及肝纤维化指标的影响

Effect of kurarinone on serum TGF-β1,TNF-α and liver fibrosis index in patients with chronic hepatitis B

目的 探讨苦参素在慢性乙型肝炎中抗肝纤维化的作用机制。方法 采用ELISA和RIA方法对治疗Ⅰ组 (对照组 )和治疗Ⅱ组 (苦参素组 )患者治疗前及治疗 3月后的慢性肝炎轻度、中度、重度及肝硬化患者 171例血清转化生长因子 β1(TGF - β1)、肿瘤坏死因子α(TNF -α)、透明质酸 (HA)、Ⅲ型前胶原 (PcⅢ )、Ⅳ胶原 (C -Ⅳ )、层连蛋白 (LN)含量进行测定 ,并设立 30例健康献血人员作为正常组。结果 治疗前两组患者血清TGF - β1、TNF -α、HA、PcⅢ、C -Ⅳ、LN均不同程度的升高 ,与正常组相比差异有显著性意义 (P <0 0 5或P <0 0 1) ;治疗后均有不同程度的降低 ,治疗Ⅱ组治疗后与治疗前相比明显下降(P <0 0 5或P <0 0 1) ,并与治疗Ⅰ组在慢性肝炎中度、重度、肝硬化间差异有显著性意义 (P <0 0 5或P <0 0 1)。结论 苦参素具有逆转肝纤维化的作用 ,有部分机制通过抑制TGF - β1、TNF -α的分泌 。

Objective To investigate the mechanism of therapeutic effect of kurarinone on liver fibrosis in patients with chronic hepatitis B.Methods The levels of transforming growth factor-β1 (TGF-β1),tumor necrosis factor-α (TNF-α),hyaline acid (HA),type Ⅲ procollagen (PcⅢ),collagen type Ⅳ (C-Ⅳ) and laminin (LN) in 171 patients with chronic mild,moderate,severe hepatitis B and liver cirrhosis were assayed by ELISA and RIA before treatment and three monthes after treatment in group Ⅰ positive control and group Ⅱ (kurarinone-treated),and 35 healthy blood donors served as normal control group.Results Before treatment,the serum levels of TGF-β1,TNF-α,HA,PcⅢ,C-Ⅳ, and LN in patients with chronic hepatitis B were remarkably higher than those in normal control group with significant differences(P<0.05 or P<0.01).After treatment,the serum levels of TGF-β1,TNF-α,HA,PcⅢ,C-Ⅳ,and LN in groups Ⅰ and Ⅱ decreased in varying degrees;the same parameters in group Ⅱ significantly decreased,compared with those before treatment (P<0.05 or P<0.01),and also were lower than those in group Ⅰ significant differences (P<0.05 or P<0.01).Conclusions Kurarinone can reverse the processs of liver fibrosis,which is effected partly by inhibiting the secretion of TGF-β1,and TNF-α.The patients have a good tolerance to the drug.