摘要
目的:观察前列地尔治疗对乙型肝炎病毒(Hepatitis B virus,HBV)感染失代偿期肝硬化难治性腹水患者肝纤维化程度、病毒学指标的影响。方法:选取我科2018年9月至2020年12月期间收治的95例HBV感染失代偿期肝硬化难治性腹水患者,采用随机数字表法进行分组,对照组47例患者给予口服恩替卡韦片治疗(0.5 mg,Qd),观察组在此基础上联合前列地尔(10μg,静脉滴注,Qd)治疗,治疗30 d后对比两组患者腹水消退情况,并采用酶联免疫吸附法测定乙肝病毒的脱氧核糖核酸(Hepatitis B Virus DNA,HBV DNA)、乙型肝炎病毒表面抗原(Hepatitis B virus surface antigen,HBsAg)及乙型肝炎病毒e抗原(Hepatitis Be antigen,HBeAg)的转阴率等病毒学指标,采用放射免疫法测定Ⅳ型胶原(Collagen type IV,CIV)、Ⅲ型前胶原(Type ⅢProcollage,PCⅢ)、层粘连蛋白(Laminin,LN)及透明质酸(Hyaluronic acid,HA)等肝纤维化指标。结果:治疗30 d后,观察组患者24 h尿量高于对照组;腹围、体重及腹水深度参数均明显低于对照组(P<0.05);观察组HBV DNA、HBsAg及HBsAg的转阴率均高于对照组(P<0.05);观察组CIV、PCⅢ、LN及HA水平均低于对照组(P<0.05);观察组不良反应发生率与对照组相比无统计学差异(P>0.05)。结论:在常规治疗基础上增加前列地尔可有效降低肝细胞纤维化程度,加强肝细胞抗病毒能力,促进腹水消退。
Objective:To observe the effects of alprostadil on liver fibrosis degree and virology indexes in patients with refractory ascites in decompensated stage of Hepatitis B virus(HBV)infection.Methods:A total of 95 patients with refractory ascites due to decompensated HBV infection and cirrhosis who were admitted to our department from September 2018 to December 2020 were divided into two groups(n=47)by random number table method.The patients in control group received oral entecavir tablets(0.5 mg,Qd),and the patients in observation group received oral entecavir tablets(0.5 mg,Qd)combined with alprostol(10μg,iv,Qd)treatment.After 30 days of treatment,ascites regression was compared between the two groups,and at the same time Hepatitis B virus deoxyribonucleic acid(HBV DNA),hepatitis B virus surface antigen(HBsAg)and hepatitis B virus e antigen(HBeAg)were determined by elisa,radioimmunoassay was used to measure collagen type IV(CIV),type III Procollage(PCⅢ),Laminin(LN)and hyaluronic acid(HA).Results:After 30 days of treatment,24 h urine volume in observation group was higher than that in control group.Abdominal circumference,body weight and ascites depth were significantly lower than those in control group(P<0.05).The negative rates of HBV DNA,HBsAg and HBsAg in observation group were higher than those in control group(P<0.05).The levels of CIV,PCⅢ,LN and HA in observation group were lower than those in control group(P<0.05).the observation group turned negative for HBV DNA,HBsAg and HBsAg The rates were higher than those of the control group(P<0.05);the CIV,PCⅢ,LN and HA levels of the observation group were lower than those of the control group(P<0.05);there was no significant difference in adverse reactions between the observation group and the control group(P>0.05).Conclusion:Alprostadil on the basis of conventional treatment can effectively reduce the fibrosis degree of liver cells,strengthen the antiviral ability of liver cells,and promote ascites regression.
作者
王晓梅
班志芬
李波
Wang Xiao-mei;Ban Zhi-fen;Li Bo(Department of Gastroenterology,The First People's Hospital of Xinxiang,Xinxiang 453000,Henan,China)
出处
《四川生理科学杂志》
2022年第7期1188-1191,共4页
Sichuan Journal of Physiological Sciences
关键词
前列地尔
HBV感染
失代偿期肝硬化
难治性腹水
病毒学指标
肝纤维化
Alprostadil
HBV infection
Decompensated liver cirrhosis
Refractory ascites
Virological indicators
liver fibrosis
