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目的:探讨替米沙坦联合干扰素治疗对慢性乙肝患者肝纤维化的影响。方法:选取既往未行抗病毒治疗的HBVDNA阳性的慢性乙肝患者50例,随机分为观察组及对照组。对照组予以普通干扰素治疗,观察组在普通干扰素治疗的基础上加用替米沙坦80 mg口服,每日一次。治疗周期48周。治疗前后分别行血清肝纤维化指标及肝脏组织病理学检查,并通过免疫组化方法测定TGF-β1、TIMP-1、MMP-1及α-SMA的表达及含量。结果:治疗后,观察组及对照组血清肝纤维化指标(HA、Ⅳ-C、LN、PIIIP)、肝纤维化分级水平及肝纤维化半定量计分较治疗前均下降,且观察组下降更明显,治疗前后,观察组和对照组肝组织中TGF-β1、TIMP-1及α-SMA表达水平明显下降,MMP-1水平明显升高,以观察组变化更为显著。结论:干扰素抗病毒的同时有抗肝纤维化作用,加用替米沙坦后抗肝纤维化作用更明显,提示替米沙坦与干扰素有协同抗纤维化作用。
Objective: To investigate the effect of telmisartan combined with interferon on liver fibrosis in patients with chronic hepatitis B Methods: Fifty patients with HBVDNA-positive chronic hepatitis B who had never been treated with antiviral therapy were randomly divided into observation group and control group. The control group was treated with ordinary interferon. The observation group was treated with telmisartan 80 mg orally once daily on the basis of ordinary interferon treatment. The treatment cycle of 48 weeks. Serum levels of hepatic fibrosis and liver histopathology were measured before and after treatment. The expressions and contents of TGF-β1, TIMP-1, MMP-1 and α-SMA were measured by immunohistochemistry. Results: After treatment, the serum levels of hepatic fibrosis (HA, IV-C, LN, PIIIP), hepatic fibrosis grade and hepatic fibrosis semi-quantitative scores in observation group and control group decreased compared with before treatment, and the observation group decreased Obviously, before and after treatment, the expression of TGF-β1, TIMP-1 and α-SMA in the liver tissue of the observation group and the control group were significantly decreased, the MMP-1 level was significantly increased, and the changes in the observation group were more significant. Conclusion: Interferon anti-virus has anti-hepatic fibrosis at the same time. The effect of anti-liver fibrosis after adding telmisartan is more obvious, suggesting that telmisartan and interferon have synergistic anti-fibrosis effect.