摘要
目的探究美他多辛联合硫普罗宁对于酒精性肝病肝纤维化及谷草转氨酶、谷丙转氨酶、谷氨酰转肽酶水平的影响。方法选择2017年12月至2018年12月于海南省琼海市中医院消化内科进行治疗的酒精性肝病患者64例,按照随机数字表法分为对照组和观察组,每组32例。两组患者均予以硫普罗宁口服治疗,观察组在此基础上加用美他多辛,持续治疗6个月。观察并比较两组患者治疗前后的肝纤维化指标、肝功能、影像检查结果、血脂指标、凝血功能及治疗有效率。结果观察组治疗总有效率为96.9%,高于对照组的53.1%,差异有显著性(P<0.05)。治疗后,肝纤维化方面,观察组透明质酸、层粘连蛋白、Ⅲ型前胶原蛋白、Ⅳ型胶原水平分别为(89.5±9.1)μg/L、(68.4±6.9)μg/L、(85.3±8.9)μg/L、(67.4±6.8)μg/L,对照组分别为(148.5±14.3)μg/L、(105.9±10.8)μg/L、(150.7±15.3)μg/L、(121.3±12.5)μg/L,两组比较差异有显著性(P<0.05);肝功能方面,观察组谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶、总胆红素、肝功能血浆白蛋白与球蛋白比值分别为(38.7±3.9)U/L、(39.0±4.1)U/L、(51.1±5.2)U/L、(25.4±2.3)U/L、1.6±0.5,对照组分别为(55.9±5.7)U/L、(58.7±5.2)U/L、(70.2±6.8)U/L、(49.3±5.1)U/L、1.3±0.4,两组比较差异有显著性(P<0.05);观察组门静脉内径及脾静脉内径均小于对照组(P<0.05);观察组总胆固醇、甘油三酯、低密度脂蛋白低于对照组,高密度脂蛋白高于对照组(P<0.05);观察组凝血酶原时间、活化部分凝血时间、凝血酶时间短于对照组,纤维蛋白原水平高于对照组(P<0.05)。结论美他多辛联合硫普罗宁治疗酒精性肝病能够有效改善患者肝功能,降低转氨酶水平,抑制肝纤维化进程。
Objective To investigate the effects on liver fibrosis and the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and glutamyl transpeptidase(GGT)in patients with alcoholic liver disease(ALD)by using metoprolol combined with tiopronin.Method Sixtyfour ALD patients treated in the hepatology department of our hospital between December 2017 and December 2018 were selected and randomly divided into the control group and the observation group,with 32 cases in each group.Both groups of patients were treated with tiopronin orally,and the observation group was additionally treated with metoprolol,continuous treatment for 6 months.The indexes of liver fi brosis,liver function,imaging results,the level of blood lipid and coagulation function and treatment effi ciency of the two groups were compared.Result The total eff ective rate of the observation group and the control group was(96.9%,53.1%,P<0.05).After treatment,the levels of hyaluronic acid,laminin,typeⅢprocollagen and typeⅣcollagen in the observation group were(89.5±9.1)μg/L,(68.4±6.9)μg/L,(85.3±8.9)μg/L,(67.4±6.8)μg/L respectively,while those in the control group were(148.5±14.3)μg/L,(105.9±10.8)μg/L,(150.7±15.3)μg/L,(121.3±12.5)μg/L respectively,with signifi cant diff erences between the two groups(P<0.05);In terms of liver function,the levels of glutamic-pyruvic transaminase,glutamic-oxaloacetic transaminase,glutamyl transpeptidase,total bilirubin and liver function white ball ratio in the observation group were(38.7±3.9)U/L,(39.0±4.1)U/L,(51.1±5.2)U/L,(25.4±2.3)U/L,1.6±0.5 respectively,while those in the control group were(55.9±5.7)U/L,(58.7±5.2)U/L,(70.2±6.8)U/L,(49.3±5.1)U/L,1.3±0.4,respectively,with signifi cant diff erences between the two groups(P<0.05);The diameter of portal vein and splenic vein in the observation group were smaller than those in the control group(P<0.05).Total cholesterol,triglyceride and low density lipoprotein in the observation group were lower than those in the control group,while high density lipoprotein was higher than that in the control group(P<0.05).The prothrombin time,activated partial coagulation time and thrombin time in the observation group were shorter than those in the control group,and the level of fi brinogen in the observation group was higher than that in the control group(P<0.05).Conclusion Metadoxine combined with Tiopronin in the treatment of ALD can eff ectively improve liver function,reduce the level of Transaminase and inhibit liver fi brosis.
作者
黄帅
陈文玲
HUANG Shuai;CHEN Wen-ling(Department of Gastroenterology,Qionghai Hospital of Traditional Chinese Medicine,Hainan Qionghai 571400,China;Department of Traditional Medicine,People's Hospital Affi liated to Fujian University of Traditional Chinese Medicine,Fujian Fuzhou 350004,China)
出处
《中国医刊》
CAS
2020年第3期263-268,共6页
Chinese Journal of Medicine
关键词
硫普罗宁
美他多辛
酒精性肝病
肝纤维化
转氨酶
门静脉高压
Tiopronin
Metadoxine
Alcoholic liver disease
Liver fi brosis
Transaminase
Portal hypertension
