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目的:观察苦参碱联合干扰素对慢性乙肝纤维化症状体征的缓解情况及对血清干扰素γ(IFN-γ)含量的影响。方法:将126例慢性乙型肝炎患者随机分为2组,治疗组66例采用苦参碱联合干扰素治疗,对照组60例采用干扰素治疗,6月后观察2组患者肝功能、乙肝病毒标志物、肝纤维4项及IFN-γ含量。结果:2组均能显著降低血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、透明质酸(HA)、Ⅲ型胶原(PCⅢ)、层黏蛋白(LN)、Ⅳ型胶原(Ⅳ-C),提高白蛋白/球蛋白比值(A/G),升高血清IFN-γ含量(P<0.01);在降低ALT、AST、HA、PCⅢ、Ⅳ-C方面,治疗组明显优于对照组(P<0.05);对照组乙肝病毒脱氧核糖核酸(HBV-DNA)阴转率高于治疗组(P<0.05),治疗组乙型肝炎E抗原(HBeAg)阴转率优于对照组(P<0.01)。结论:苦参碱联合干扰素可升高血清IFN-γ含量,抑制肝纤维化,同时还可抑制病毒复制,促进HBV复制标志物阴转,降低转氨酶,改善肝功能。
OBJECTIVE: To observe the relief of symptoms and signs of chronic hepatitis B and the effect of matrine combined with interferon on the serum level of interferon-γ (IFN-γ). Methods: 126 patients with chronic hepatitis B were randomly divided into two groups. 66 cases in the treatment group were treated with matrine and interferon, 60 cases in the control group were treated with interferon. After 6 months, the liver function, hepatitis B virus Markers, liver fiber 4 and IFN-γ content. Results: The levels of serum ALT, AST, HA, PCⅢ, LN, Ⅳ-C ), Raise the ratio of albumin / globulin (A / G) and increase the level of serum IFN-γ (P <0.01). The treatment group was significantly better than the control group in reducing ALT, AST, HA, PCⅢ, (P <0.05). The negative conversion rate of hepatitis B virus DNA (HBV-DNA) in the control group was higher than that in the treatment group (P <0.05), and the negative conversion rate of HBeAg in the treatment group was higher than that of the control group <0.01). Conclusion: Matrine combined with interferon can increase the level of serum IFN-γ, inhibit liver fibrosis, inhibit the replication of virus, promote the negative conversion of HBV replication markers, decrease transaminase and improve liver function.