Feng Jing, Huang Jiandong, Li Zhiqin
Department of Infectious Diseases, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China.
Exp Ther Med. 2017 Dec;14(6):5837-5842. doi: 10.3892/etm.2017.5266. Epub 2017 Oct 6.
This study aimed to explore the effect of kushenin combined with adefovir dipivoxil on the load of hepatitis B virus DNA (HBV-DNA) in serum, in immune functions and in liver functions of patients with chronic hepatitis B. A sample of 80 patients with chronic hepatitis B was selected who were admitted to Weifang People's Hospital for treatment between January, 2013 and December, 2015. They were divided into the observation group (n=40) and the control group (n=40). The patients in both groups received adefovir dipivoxil, while those in the observation group additionally received the kushenin. Variations in HBV-DNA load and transforming growth factor-β1 (TGF-β1) in the two groups were detected before intervention, at 1 month, 3 months and 6 months after intervention. In addition, after intervention, we also observed the changes in CD4, CD8 and CD4/CD8, as well as the levels of immune globulin. Furthermore, in these two groups, we detected the changes in endotoxin in serum before and after intervention, the liver function after intervention, and the variations of hyaluronic acid (HA) and type III procollagen (PCIII) before and after intervention which were used to serve as the indicators for hepatic fibrosis. Results showed that at one month, 3 months and 6 months after intervention, HBV-DNA load and the level of TGF-β1 in the observation group were lower than those in the control group (P<0.05). In the observation group, the HBV-DNA load at 6 months after intervention was the lowest, sequentially followed by the levels at 3 months, at 1 month and before intervention (P<0.05). After intervention, the levels of CD4 and CD8 and CD4/CD8 in the observation group were higher than those in the control group (P<0.05). Moreover, the levels of immunoglobulin M (IgM), immunoglobulin G (IgG) and immunoglobulin A (IgA) were elevated in the observation group compared to the levels in the control group (P<0.05). Additionally, the level of endotoxin in serum, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil). Besides, after intervention, the levels of HA and PCIII in the observation group were found to be lower than those in the control group before and after intervention (P<0.05). This study concludes that, for patients with chronic hepatitis B, kushenin combined with adefovir dipivoxil can remarkably decrease the HBV-DNA load, improve their immunity, ameliorate the liver function and delay the onset of liver cirrhosis.
本研究旨在探讨苦参素联合阿德福韦酯对慢性乙型肝炎患者血清乙肝病毒脱氧核糖核酸(HBV-DNA)载量、免疫功能及肝功能的影响。选取2013年1月至2015年12月在潍坊市人民医院住院治疗的80例慢性乙型肝炎患者作为研究对象,将其分为观察组(n = 40)和对照组(n = 40)。两组患者均接受阿德福韦酯治疗,观察组患者在此基础上联合应用苦参素。分别于干预前、干预后1个月、3个月及6个月检测两组患者HBV-DNA载量及转化生长因子-β1(TGF-β1)的变化情况。此外,干预后观察两组患者CD4、CD8及CD4/CD8的变化情况以及免疫球蛋白水平。同时,检测两组患者干预前后血清内毒素水平、干预后肝功能以及干预前后透明质酸(HA)和Ⅲ型前胶原(PCIII)的变化情况,以作为肝纤维化的指标。结果显示,干预后1个月、3个月及6个月,观察组患者HBV-DNA载量及TGF-β1水平均低于对照组(P < 0.05)。观察组患者干预后6个月时HBV-DNA载量最低,依次为干预后3个月、1个月及干预前(P < 0.05)。干预后,观察组患者CD4、CD8及CD4/CD8水平均高于对照组(P < 0.05)。此外,观察组患者免疫球蛋白M(IgM)、免疫球蛋白G(IgG)及免疫球蛋白A(IgA)水平均高于对照组(P < 0.05)。另外,观察组患者血清内毒素水平、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及总胆红素(TBil)水平均降低。此外,干预后观察组患者HA及PCIII水平均低于对照组干预前后水平(P < 0.05)。本研究得出结论,对于慢性乙型肝炎患者,苦参素联合阿德福韦酯可显著降低HBV-DNA载量,提高机体免疫力,改善肝功能,延缓肝硬化的发生。