艾塞那肽联合多烯磷脂酰胆碱治疗酒精性肝炎患者初步疗效研究*

doi:10.3969/j.issn.1672-5069.2025.05.019

摘要/Abstract

摘要： 目的观察应用艾塞那肽联合多烯磷脂酰胆碱治疗酒精性肝炎(AH)患者的疗效。方法 2022年1月～2024年1月我院收治的AH患者102例,被随机分为对照组50例,接受多烯磷脂酰胆碱治疗,和观察组52例,接受艾塞那肽联合多烯磷脂酰胆碱治疗3个月。采用放射免疫法检测血清透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、胶原纤维Ⅳ(Ⅳ-C)和层粘连蛋白(LN),采用ELISA法检测血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和IL-8水平。结果在治疗结束时,观察组血清ALT、AST、GGT和TBIL水平分别为(48.9±15.2)U/L、(45.6±12.5)U/L、(119.5±30.6)U/L和(23.1±5.6)μmol/L,均显著低于对照组【分别为(69.3±20.1)U/L、(79.6±18.1)U/L、(168.8±50.7)U/L和(33.5±6.9)μmol/L,P<0.05】;观察组血清HA、PC-Ⅲ、Ⅳ-C和LN水平分别为(128.5±20.3)μg/L、(132.3±29.1)μg/L、(41.2±9.1)mg/mL和(105.4±20.6)mg/mL,均显著低于对照组【分别为(152.2±22.1)μg/L、(186.5±30.4)μg/L、(57.3±10.2)mg/mL和(134.5±20.1)mg/mL,P<0.05】;观察组血清TNF-α、IL-6和IL-8水平分别为(236.1±100.8)pg/L、(35.1±10.8)pg/L和(10.5±3.8)ng/L,均显著低于对照组【分别为(286.7±105.6)pg/L、(50.1±11.4)pg/L和(17.1±4.5)ng/L,P<0.05】;两组不良反应发生率分别为13.5%和10.0%,无显著性差异(P＞0.05)。结论在多烯磷脂酰胆碱治疗基础上加用艾塞那肽治疗AH患者可进一步改善肝功能,可能与减轻了机体炎症反应有关。

关键词: 酒精性肝炎, 艾塞那肽, 多烯磷脂酰胆碱, 治疗

Abstract: Objective The aim of this study was to investigate therapeutic efficacy of exenatideplus oralpolyenephosphatidylcholine in the treatment of patients with alcoholic hepatitis (AH). Method A total of 102 patients with AH were recruited in our hospital between January 2022 and January 2024,and were randomly assigned to receive oral polyene phosphatidylcholine in 50 patients in control, or receive subcutaneous exenatide injection plus oral polyene phosphatidylcholine in 52 patients in combination group for three months. Serum hyaluronic acid (HA), type III procollagen (PC-Ⅲ), collagen fiber Ⅳ (ⅳ-C) and laminin (LN)) levels were detected by radioimmunoassay, and serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-8 levels were assayed by ELISA. Result By end of three month treatment, serum ALT, AST,GGT and total bilirubin levels in combination groupwere(48.9±15.2)U/L, (45.6±12.5)U/L, (119.5±30.6)U/L and (23.1±5.6)μmol/L, all significantly lower than [(69.3±20.1)U/L,(79.6±18.1)U/L, (168.8±50.7)U/Land (33.5±6.9)μmol/L,respectively, P<0.05] in the control; serum HA, PC-Ⅲ,Ⅳ-C and LN levels in the combination group were (128.5±20.3)μg/L, (132.3±29.1)μg/L, (41.2±9.1)mg/mL and (105.4±20.6)mg/mL, all significantly lower than [(152.2±22.1)μg/L, (186.5±30.4)μg/L, (57.3±10.2)mg/mL and (134.5±20.1)mg/mL, respectively, P<0.05] in the control group; serum TNF-α,IL-6 and IL-8 levels in the combination group were (236.1±100.8)pg/L, (35.1±10.8)pg/L and (10.5±3.8)ng/L, all much lower than [(286.7±105.6)pg/L, (50.1±11.4)pg/L and (17.1±4.5)ng/L, respectively, P<0.05] in the control group; there was no significant difference in the incidence of adverse reactions between the two groups (13.5% vs. 10.0%, P>0.05). Conclusion Additional injection of exenatideat basis of oral polyenephosphatidylcholine therapy could improve liver function normal in patients with alcoholic hepatitis, which might be related to inhibition of body inflammatory reactions.

Key words: Alcoholic hepatitis, Exenatide, Polyenephosphatidylcholine, Therapy

王霞, 段旺旺, 李梦辉. 艾塞那肽联合多烯磷脂酰胆碱治疗酒精性肝炎患者初步疗效研究^*[J]. 实用肝脏病杂志, 2025, 28(5): 715-718.

Wang Xia, DuanWangwang, Li Menghui. Application of exenatide at base of oral polyenephosphatidylcholine in treatment of patients with alcoholic hepatitis[J]. Journal of Practical Hepatology, 2025, 28(5): 715-718.

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艾塞那肽联合多烯磷脂酰胆碱治疗酒精性肝炎患者初步疗效研究^*

Application of exenatide at base of oral polyenephosphatidylcholine in treatment of patients with alcoholic hepatitis

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