摘要
目的研究双歧杆菌四联活菌片联合富马酸替诺福韦应用于乙肝肝纤维化(LF)的效果,并分析对肠黏膜屏障功能的影响。方法选取2019年1月至2022年1月郑州大学第五附属医院收治的91例乙肝LF患者,以随机数字表法分为对照组(46例)和观察组(45例)。对照组接受富马酸替诺福韦,观察组接受双歧杆菌四联活菌片联合富马酸替诺福韦。比较两组临床疗效、治疗前、治疗24周后肝功能[白蛋白(ALB)、谷草转氨酶(AST)、总胆红素(TBIL)、谷丙转氨酶(ALT)]、LF生化指标[Ⅳ型胶原(Ⅳ-C)、测定透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)]、肠黏膜屏障功能[D-乳酸、内毒素、二胺氧化酶(DAO)]及炎症因子[肿瘤坏死因子α(TNF-α)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-22]水平。结果观察组临床总有效率(97.78%)高于对照组(82.61%)(P<0.05);治疗24周后观察组血清AST、ALT、TBIL、Ⅳ-C、HA、PCⅢ、LN水平均低于对照组,ALB水平高于对照组(P<0.05);治疗24周后观察组血清D-乳酸、内毒素、DAO、TNF-α、PCT、IL-6、IL-22水平均低于对照组(P<0.05);两组不良反应发生率对比,差异无统计学意义(χ^(2)=0.203,P=0.653)。结论双歧杆菌四联活菌片联合富马酸替诺福韦应用于乙肝LF患者疗效确切,可减轻炎症反应,提高肝功能、肠黏膜屏障功能,缓解纤维化,促进病情转归,且未提高明显不良反应发生率。
Objective To study the effect of bifidobacterium tetravaccine tablets combined with tenofovir fumarate applied to hepatitis B liver fibrosis(LF)and to analyze the effect on biochemical indexes and intestinal mucosal barrier function of LF.Methods Ninety-one patients with hepatitis B LF admitted to the Fifth Affiliated Hospital of Zhengzhou University from January 2019 to January 2022 were selected and divided into control group(46 cases)and observation group(45 cases)by random number table method.Tenofovir fumarate was used in the control group,and bifidobacterium tetravaccine tablets combined with tenofovir fumarate was used in the observation group.The clinical efficacy,liver function[albumin(ALB),aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT)],LF biochemical indexes[typeⅣcollagen(Ⅳ-C),determination of hyaluronic acid(HA),pre-collagen typeⅢ(PCⅢ),laminin(LN)],intestinal mucosal barrier function[D-lactate,endotoxin,diamine oxidase(DAO)]and inflammatory factors[tumor necrosis factor alpha(TNF-α),calcitoninogen(PCT),interleukin-6(IL-6),IL-22]levels were compared between the two groups before and 24 weeks after treatment.Results The total clinical efficiency of the observation group(97.78%)was higher than that of the control group(82.61%)(P<0.05).The serum AST,ALT,TBIL,Ⅳ-C,HA,PCⅢand LN levels of the observation group were lower than those of the control group,and the ALB levels were higher than those of the control group after 24 weeks of treatment(P<0.05).The serum D-lactate,endotoxin,DAO,TNF-α,PCT,IL-6,IL-22 levels were lower than those of the control group after 24 weeks of treatment(P<0.05).Conclusion Bifidobacterium tetravaccine tablets combined with tenofovir fumarate is effective in patients with hepatitis B LF,reducing inflammation,improving liver function and intestinal mucosal barrier function,alleviating fibrosis and promoting regression.
作者
韩蕊蕊
孙会卿
HAN Ruirui;SUN Huiqing(Department of Infectious Diseases,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450015,China)
出处
《河南医学研究》
CAS
2022年第23期4362-4366,共5页
Henan Medical Research
关键词
乙肝
肝纤维化
双歧杆菌四联活菌片
富马酸替诺福韦
肠黏膜
屏障功能
hepatitis B
liver fibrosis
bifidobacterium tetravaccine tablets
tenofovir fumarate
intestinal mucosa
barrier function
