摘要
目的从组织病理学和血清学二方面探讨苦参素治疗慢性乙型肝炎肝纤维化的作用。方法临床和病理诊断为慢性乙型肝炎肝纤维化的病人122例，其中72例给予苦参素葡萄糖溶液静脉滴注，1次，d，连用6个月。另50例作为对照，给予γ-干扰素100万单位皮下注射，1次，d，连用3个月，后改为隔天1次，再用3个月，分别于治疗前后进行肝脏组织病理学和血清学检查。结果苦参素治疗后肝组织炎症活动度明显改善（炎症活动度计分比较P〈0．01）、肝组织纤维化程度也明显改善（组织纤维化程度计分P〈0．05）。而单项评分显示苦参素治疗后汇管区炎症（P〈0．05）、小叶内炎症（P〈0．01）、中央静脉窦周纤维化（P〈0．05）、碎屑样坏死（P〈0．01）、汇管区纤维化（P〈0．01）明显减轻。血纤维化指标检测显示，苦参素治疗后血透明质酸（HA）明显减少（P〈0．01），而Ⅲ型前胶原（PCⅢ）、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）减少不明显。肝脏组织病理学和血纤维化指标检测显示治疗组与对照组无显著差异。肝功能检测结果，苦参素治疗后血清丙氨酸氨基转移酶（ALT）和血清总胆红素（TB）无明显变化，而白蛋白（Alb）明显增高（P〈0．01）。结论苦参素具有减轻慢性乙型肝炎肝纤维化病人肝组织炎症和纤维化的作用，同时具有一定的改善肝功能作用。
Objective To investigate the effects of oxymatrine on chronic hepatitis with hepatic fibrosis by histopathological and serological analysis. Methods 122 cases of patients diagnosed as chronic hepatitis with hepatic fibrosis by clinic and pathology were randomly divided into two groups. 72 patients in one group injected oxymatrine glucose injection intravenously once a day for 6 months. 52 patients in the other group injected interferon- γ hypodermically once a day for 3 months and once every two days for further 3 months. Histopathological and serological examinations were conducted before and after treatment. Results After oxymattrine treatment, hepatic inflammatory grade was improved remarkably （P〈0.01）, and degree of hepatic fibrosis was statistically reduced （P〈0.05）. When evaluated respectively, portal inflammation （P〈0.05）, lobular inflammation （P〈0.01）, central vein and fenestrae fibrosis （P〈0.05）, piecemeal necrosis （P〈0.01）, portal fibrosis （P〈0.01） decreased significantly. Detection of fibrotic markers in serum showed that HA was decreased after oxymatrine treatment （P〈0.01）, but PCⅢ, LN, Ⅳ-C had no statistical reduction. By histopathological and serological comparison, oxymatrine has almost the same effect as interferon-γ on improving hepatic inflammation and hepatic fibrosis. Liver biochemical detection showed that Alb increased obviously after oxymatrine treatment, ALT and AST had no obvious changes. Conclusion Oxymatrine might have the effect on ameliorating inflammation and fibrosis in the patients with chronic hepatitis with hepatic fibrosis and on improving their liver function.
出处
《世界感染杂志》
2005年第4期289-292,共4页
World Journal of Infection
作者简介
Ye Jun （1955-）, male （Han nationality） born in Shanghai city, vice dean of internal medicine, specialize in basic and clinical studies on viral hepatitis and infectious deseases, having morethan 10 paper published.
