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[目的]观察苦参素对丙肝失代偿期肝硬化患者的抗纤维化和免疫调节作用,以及分析了其相关的临床疗效。[方法]收集2013年3月~2015年2月我院收治的丙肝失代偿期肝硬化患者76例,随机分为常规治疗对照组和苦参素治疗组,每组38例。比较2组治疗前后HA、LN、PCⅢ、CⅣ、IL-17、IL-10、HCV-RNA病毒载量和Child-Pugh评分的变化。[结果]治疗前2组HA、LN、PCⅢ和CⅣ表达差异无统计学意义(P>0.05),治疗后2组均出现显著减低(P<0.05和P<0.01)。但治疗组的减低作用显著高于对照组(P<0.01)。治疗前2组IL-17和IL-10表达差异无统计学意义(P>0.05),治疗后2组IL-17和IL-10表达均出现显著改变(P<0.05和P<0.01),但治疗组对IL-17和IL-10表达的改善作用优于对照组(P<0.05)。治疗前2组Child-Pugh评分和HCV-RNA病毒载量差异无统计学意义(P>0.05),治疗后2组均出现显著减低(P<0.05和P<0.01)。但治疗组的减低作用显著高于对照组(P<0.01)。[结论]苦参素可以调节丙肝失代偿期肝硬化患者体内Th17/Treg免疫失衡,发挥抗纤维化作用,显著减低Child-Pugh评分和HCV-RNA病毒载量,临床疗效显著,值得临床推广使用。
[Objective] To observe the anti-fibrosis and immunomodulatory effects of oxymatrine on decompensated cirrhotic patients with hepatitis C, and to analyze its clinical effect. [Methods] A total of 76 patients with decompensated liver cirrhosis who were treated in our hospital from March 2013 to February 2015 were randomly divided into routine treatment control group and oxymatrine treatment group, with 38 patients in each group. The changes of HA, LN, PCⅢ, CⅣ, IL-17, IL-10, HCV-RNA viral load and Child-Pugh score before and after treatment were compared between the two groups. [Results] There was no significant difference in the expression of HA, LN, PCⅢ and CⅣ between the two groups before treatment (P> 0.05). After treatment, the levels of HA, LN, PCⅢ and CⅣ were significantly decreased in both groups (P <0.05 and P <0.01). However, the reduction effect of the treatment group was significantly higher than that of the control group (P <0.01). There was no significant difference in IL-17 and IL-10 expression between the two groups before treatment (P> 0.05). After treatment, the expressions of IL-17 and IL-10 in two groups were significantly changed (P <0.05 and P <0.01) The improvement of IL-17 and IL-10 expression in the treatment group was better than that in the control group (P <0.05). There was no significant difference in Child-Pugh score and HCV-RNA viral load between the two groups before treatment (P> 0.05). After treatment, the two groups were significantly reduced (P <0.05 and P <0.01). However, the reduction effect of the treatment group was significantly higher than that of the control group (P <0.01). [Conclusion] Oxymatrine can modulate immune imbalance of Th17 / Treg in patients with decompensated liver cirrhosis, play an anti-fibrosis effect, significantly reduce Child-Pugh score and HCV-RNA viral load, and have significant clinical effect and worthy of clinical promotion use.