水飞蓟素联合复方蛋氨酸胆碱治疗酒精性肝炎患者疗效及其对血清肝纤维化指标的影响*

doi:10.3969/j.issn.1672-5069.2024.03.008

摘要/Abstract

摘要： 目的观察应用水飞蓟素联合复方蛋氨酸胆碱治疗酒精性肝炎(AH)患者的临床疗效及其对血清肝纤维化指标的影响。方法 2021年1月～2023年1月我院诊治的AH患者101例,采用随机数字表法将患者分为对照组50例和观察组51例,分别给予复方蛋氨酸胆碱或复方蛋氨酸胆碱联合水飞蓟素治疗6个月。采用放射免疫分析法检测血清层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原N端肽(PCⅢ)和Ⅳ型胶原(Ⅳ-C),采用ELISA法检测血清过氧化物酶体增殖物激活受体γ(PPARγ)、瘦素(LEP)、脂联素(APN)和白细胞介素-18(IL-18)水平。结果经治疗,观察组血清ALT和AST水平分别为(41.8±4.9)IU/L和(42.5±4.9)IU/L,均显著低于对照组【分别为(75.3±6.8)IU/L和(62.7±5.8)IU/L,P<0.05】;观察组血清HA、PCⅢ和Ⅳ-C水平分别为(103.6±13.5)μg/L、(94.2±9.8)μg/L和(75.2±8.6)μg/L,均显著低于对照组【分别为(146.2±15.3)μg/L、(125.8±13.3)μg/L和(112.3±14.5)μg/L,P<0.05】;观察组血清PPARγ、LEP和IL-18水平分别为(231.7±26.8)pg/mL、(5.4±0.7)μg/L和(92.5±11.7)ng/mL,均显著低于对照组【分别为(285.3±29.4)pg/mL、(8.3±0.9)μg/L和(118.5±12.4)ng/mL,P<0.05】,而血清APN水平为(15.4±1.7)ng/L,显著高于对照组【(11.3±1.9)ng/L,P<0.05】。结论应用水飞蓟素联合复方蛋氨酸胆碱治疗AH患者效果较好,有利于肝功能指标恢复,可能对延缓肝纤维化进展、降低机体炎症反应和调节脂代谢有帮助。

关键词: 酒精性肝炎, 水飞蓟素, 复方蛋氨酸胆碱, 肝纤维化, 治疗

Abstract: Objective The aim of this study was to observe the clinical efficacy of silymarin and compound methionine choline combination in treating patients with alcoholic hepatitis (AH). Methods 101 patients with AH were admitted to our hospital between January 2021 and January 2023, and were randomly divided into control (n=50) and observation (n=51) groups, receiving oral compound methionine choline or oral compound methionine choline and silymarin combination treatment for six months. The liver function tests were detected by fully automatic biochemical analyser, serum laminin (LN), hyaluronic acid (HA), type Ⅲ procollagen N-terminal peptide (PCⅢ) and type Ⅳ collage (Ⅳ-C) levels were assayed by radioimmunoassay and serum peroxisome proliferators-activated receptor γ (PPARγ), leptin (LEP), adiponectin (APN) and interleukin 18 (IL-18) were determined by ELISA. Results At the end of six-month treatment, serum alanine transferase and aspartate transaminase levels in the observation group were(41.8±4.9)IU/L and (42.5±4.9)IU/L, both significantly lower than [(75.3±6.8)IU/L and (62.7±5.8)IU/L, respectively, P<0.05] in the control group; serum HA, PCⅢ and Ⅳ-C levels in the observation group were (103.6±13.5)μg/L, (94.2±9.8)μg/L and (75.2±8.6)μg/L, all significantly lower than [(146.2±15.3)μg/L, (125.8±13.3)μg/L and (112.3±14.5)μg/L, P<0.05] in the control; serum PPARγ, LEP and IL-18 levels in the observation group were (231.7±26.8)pg/mL, (5.4±0.7)μg/L and (92.5±11.7)ng/mL, all significantly lower than [(285.3±29.4)pg/mL, (8.3±0.9)μg/L and (118.5±12.4)ng/mL, respectively, P<0.05], while serum APN level was (15.4±1.7)ng/L, significantly higher than [(11.3±1.9)ng/L, P<0.05] in the control group. Conclusion The oral administration of compound methionine choline and silymarin combination in treatment of patients with AH is short-termly efficacious, which could improve liver function tests back to normal, and relieve liver fibrosis and body inflammatory reactions.

Key words: Alcoholic hepatitis, Silymarin, Compound methionine choline, Liver fibrosis, Therapy

程艳洁, 王鹏飞, 李峻. 水飞蓟素联合复方蛋氨酸胆碱治疗酒精性肝炎患者疗效及其对血清肝纤维化指标的影响^*[J]. 实用肝脏病杂志, 2024, 27(3): 349-352.

Cheng Yanjie, Wang Pengfei, Li Jun. Clinical efficacy of silymarin and compound methionine choline combination in the treatment of patients with alcoholic hepatitis[J]. Journal of Practical Hepatology, 2024, 27(3): 349-352.

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水飞蓟素联合复方蛋氨酸胆碱治疗酒精性肝炎患者疗效及其对血清肝纤维化指标的影响^*

Clinical efficacy of silymarin and compound methionine choline combination in the treatment of patients with alcoholic hepatitis

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