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中国医药导刊 ›› 2023, Vol. 25 ›› Issue (11): 1176-1180.

• 临床医药 • 上一篇    下一篇

还原型谷胱甘肽辅助治疗慢性乙型肝炎肝纤维化的临床疗效观察

魏书堂, 徐梦阳, 董勇   

  1. 河南大学第一附属医院消化内科, 河南 开封 475000
  • 收稿日期:2023-02-17 修回日期:2023-11-28 出版日期:2023-11-28 发布日期:2023-11-28
  • 基金资助:
    河南省医学科技攻关计划(联合共建)项目(项目编号:LHGJ20190532;项目名称:NOX介导的氧化应激在肝纤维化发生发展中的作用)

Clinical Efficacy Observation of Reduced Glutathione Adjuvant Therapy for Chronic Hepatitis B Liver Fibrosis

  1. Department of Gastroenterology,the First Affiliated Hospital of Henan University, Henan Kaifeng 475000, China
  • Received:2023-02-17 Revised:2023-11-28 Online:2023-11-28 Published:2023-11-28

摘要: 目的:探究还原型谷胱甘肽辅助治疗慢性乙型肝炎(CHB)肝纤维化的临床疗效及作用机制。方法:选取我院2020年1月至2021年8月收治的98例CHB患者作为研究对象,按照随机数字表法分为研究组、常规组,每组各49例。常规组患者采用常规治疗,研究组患者在常规组治疗基础上,予以还原型谷胱甘肽治疗。比较两组患者临床疗效、治疗前后肝功能指标[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]、肝纤维化指标[Ⅳ型胶原(ⅣC)、层黏蛋白(LN)、透明质酸(HA)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、血清活性氧(ROS)、还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(NOX4)水平及治疗期间患者不良反应发生情况。结果:研究组患者治疗总有效率93.88%,高于常规组患者的79.59%(P<0.05)。治疗后,两组患者血清TBIL、AST、ALT、HA、ⅣC、LN 、ROS、NOX4水平较治疗前均降低,且研究组患者血清TBIL、AST、ALT、HA、ⅣC、LN、ROS、NOX4水平降低幅度均高于常规组(P<0.05)。治疗后,两组患者血清MDA水平较治疗前降低,SOD水平较治疗前升高,且研究组患者MDA水平降低幅度、SOD水平升高幅度均大于常规组(P<0.05)。两组患者治疗期间均未发生明显不良反应。结论:还原型谷胱甘肽辅助治疗CHB肝纤维化患者效果显著,可通过降低NOX4表达,降低ROS介导的氧化应激反应,从而改善肝功能,控制肝纤维化进程,且安全性高。

关键词: 慢性乙型肝炎, 还原型谷胱甘肽, 肝纤维化, 氧化应激, 肝功能

Abstract: Objective:To explore the clinical efficacy and mechanism of reduced glutathione adjuvant therapy for chronic hepatitis B (CHB) liver fibrosis. Methods:A total of 98 CHB patients were selected as the research subjects from January 2020 to August 2021.They were divided into the study group and the routine group according to the random number table method, with 49 cases in each group. Patients of the routine group received routine treatment, and pationts of the study group received reduced glutathione therapy on the basis of the routine group. The curative effect, liver function indexes [total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], liver fibrosis indexes [type IV collagen (IVC), laminin (LN), hyaluronic acid (HA)], oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD)], serum reactive oxygen species (ROS), reduced nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) levels before and after treatment and adverse reactions during treatment were compared between the two groups. Results: The total effective rate of the study group was 93.88%, which was higher than that of the routine group (79.59%, P<0.05). After treatment, the serum levels of TBIL, AST, ALT, HA, IVC, LN, ROS, NOX4 of patients in both groups was lower than those before treatment, and the reductions of the above indexes of the study group were all greater than those of the routine group(P<0.05). After treatment, the MDA level in the study group was lower than that of the conventional group, and the SOD level of patients in the study group was higher than that in the routine group (P<0.05). No obvious adverse reactions occurred in both groups during the treatment. Conclusion:Reduced glutathione is effective in adjuvant treatment of CHB liver fibrosis patients, which can improve liver function and control liver fibrosis process by reducing NOX4 expression and ROS-mediated oxidative stress response, and it is with high safety.

Key words: Chronic hepatitis B, Reduced glutathione, Liver fibrosis, Oxidative stress, Liver function

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