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目的 :研究苦参素胶囊联合重组人干扰素对高甲胎蛋白(AFP)慢性乙肝患者纤维化指标及炎症因子的影响及治疗效果。方法 :将2012年3月~2015年3月于我院接受诊治的96例慢性乙肝肝硬化伴高甲胎蛋白患者,根据治疗方式的不同,随机平均分为A、B、C三组,所有患者均接受复方鳖甲软肝片、水飞蓟宾葡甲胺片、甘草酸二铵保肝抗炎治疗,恩替卡韦抗乙肝病毒治疗,维生素、能量合剂等常规乙肝治疗,A组患者在此基础上给予苦参素胶囊治疗,B组患者给予干扰素-γ治疗,C组患者给予两种药物联合治疗,治疗9个月,观察三组患者治疗前后肝功能、肝纤维化指标以及炎症因子表达。结果 :经过治疗后,三组患者AFP、ALT、AST、TBil、PT均显著降低,白蛋白显著上升;A组HBV-DNA阴转率40.63%,HBe Ab阳转率31.25%,HBe Ag阴转率34.38%,B组37.50%、28.13%和31.25%,C组65.63%、56.25%和59.38%;三组LN、PCⅢ、PⅣP、HA均显著降低;脾脏厚度、内径,脾静脉宽度,门静脉内径均显著降低;炎症因子IL-6、TNF-α、BFGF及TGF-β1含量均显著降低。A、B两组差异不显著,与C组差异显著。结论 :苦参素胶囊联合重组人干扰素可显著降低慢性乙肝患者甲胎蛋白含量,改善肝纤维化状态,降低炎症反应,促进肝功能恢复。
Objective: To investigate the effect of oxymatrine capsule combined with recombinant human interferon on fibrosis index and inflammatory cytokines in chronic hepatitis B patients with high alpha-fetoprotein (AFP) and its therapeutic effect. Methods: Ninety-six patients with chronic hepatitis B cirrhosis with high-grade fetoprotein admitted to our hospital from March 2012 to March 2015 were randomly divided into three groups A, B and C according to the different treatment methods All patients underwent routine hepatitis B treatment with compound Biejia Ruangan Tablet, silybin meglumine tablet, diammonium glycyrrhizinate, anti-hepatitis B virus treatment with entecavir, vitamins and energy mixture, and patients in group A were based on this On the other hand, patients in group B were treated with interferon-γ. Patients in group C received combination therapy of two drugs for 9 months. The liver function, hepatic fibrosis indexes and inflammatory cytokines expression in three groups were observed before and after treatment . Results: After treatment, the AFP, ALT, AST, TBil, PT were significantly decreased and albumin significantly increased in group A; the negative conversion rate of HBV-DNA in group A was 40.63%, the positive conversion rate of HBe Ab was 31.25% The rates of LN, PCⅢ, PⅣP and HA in three groups were significantly lower than those in group C (P <0.05), and the rates of lymph node metastasis were 34.38%, 37.50%, 28.13% and 31.25% in group B, 65.63%, 56.25% and 59.38% Were significantly reduced; inflammatory cytokines IL-6, TNF-α, BFGF and TGF-β1 levels were significantly lower. A, B difference was not significant between the two groups, significant difference with the C group. Conclusion: Oxymatrine capsule combined with recombinant human interferon can significantly reduce the level of alpha-fetoprotein in chronic hepatitis B patients, improve the status of hepatic fibrosis, reduce the inflammatory reaction and promote the recovery of liver function.