摘要
目的 探讨水飞蓟宾胶囊对慢性乙型肝炎病毒(HBV)感染患者肝纤维化的作用,并分析对其Wnt/β-catenin信号通路的影响。方法 选取2017年6月-2019年12月乌兰察布市中心医院收治的98例慢性HBV感染患者,随机分为治疗组(n=49)和常规组(n=49),常规组患者给予常规保肝药物治疗,治疗组患者在常规组基础上给予水飞蓟宾胶囊治疗,比较治疗前后两组患者肝功能、肝纤维化以及氧化应激指标的变化,记录治疗后36周、72周两组患者HBV DNA水平和谷丙转氨酶(ALT)复常率,并采用酶联免疫吸附法检测治疗前后两组患者血清Wnt3a、β-catenin和DKK1水平。结果 治疗后,治疗组患者ALT、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)水平、透明质酸酶(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(PCⅣ)水平、丙二醛(MDA)水平和白细胞介素(IL)-4、IL-10水平低于常规组(P<0.05),超氧化物歧化酶(SOD)水平和干扰素-γ(IFN-γ)水平高于常规组(P<0.05);治疗后36、72周,治疗组患者HBV DNA水平均低于常规组(P<0.05),ALT复常率均高于常规组(P<0.05);治疗后,治疗组患者血清Wnt3a、β-catenin水平低于常规组(P<0.05),DKK1水平高于常规组(P<0.05)。结论 水飞蓟宾胶囊治疗慢性HBV感染可保护患者肝功能,抑制肝纤维化,减轻氧化应激损伤和炎症反应,阻断HBV DNA复制,促进肝功能恢复,其机制可能与调控Wnt/β-catenin信号通路有关。
OBJECTIVE To investigate the effect of Silibinin capsules on liver fibrosis in patients with chronic hepatitis B virus(HBV) infection, and to analyze its influence on Wnt/β-catenin signaling pathways. METHODS A total of 98 patients with chronic HBV infection admitted to Ulanqab Central Hospital from Jun 2017 to Dec 2019 were selected and randomly divided into treatment group(n=49) and routine group(n=49). Patients in routine group were given routine hepatoprotective drug treatment, and patients in treatment group were given Silibinin capsules on the basis of routine group. The changes in liver function, liver fibrosis and oxidative stress indexes were compared between the two groups before and after treatment, and the HBV DNA level and alanine aminotransferase(ALT) reversion rate of patients in the two groups were recorded at 36 weeks and 72 weeks after treatment. The levels of serum Wnt3 a, β-catenin and DKK1 of patients in the two groups before and after treatment were detected by enzyme linked immunosorbent assay(ELISA). RESULTS After treatment, the levels of ALT, aspartate aminotransferase(AST), γ-glutamyl transpeptidase(γ-GT), hyaluronidase(HA), laminin(LN), type Ⅲ procollagen(PC Ⅲ), type Ⅳ collagen(PC Ⅳ), malondialdehyde(MDA), interleukin(IL)-4 and IL-10 in treatment group were significantly lower than those in routine group(P<0.05), while the levels of superoxide dismutase(SOD) and interferon-γ(IFN-γ) were significantly higher than those in routine group(P<0.05). At 36 weeks and 72 weeks after treatment, the HBV DNA level of patients in treatment group was significantly lower than that in routine group(P<0.05), while the ALT reversion rate was significantly higher than that in routine group(P<0.05). After treatment, the levels of serum Wnt3 a and β-catenin in treatment group were significantly lower than those in routine group(P<0.05) while the DKK1 level was significantly higher than that in routine group(P<0.05). CONCLUSION Silibinin capsules in treating chronic HBV infection can protect liver function, inhibit liver fibrosis, relieve oxidative stress injury and inflammatory response, block HBV DNA replication, and promote liver function recovery. The mechanism may be related to the regulation of Wnt/β-catenin signaling pathways.
作者
刘俊平
郭新忠
李晓敏
罗致军
彭培英
LIU Jun-ping;GUO Xin-zhong;LI Xiao-min;LUO Zhi-jun;PENG Pei-ying(Ulanqab Medical College,Ulanqab,Inner Mongolia 012000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第3期336-340,共5页
Chinese Journal of Nosocomiology
基金
云南省教育厅科学研究基金资助项目(2021J1115)。
