关键词: 自身免疫性肝炎, 标准免疫抑制疗法, 甘草酸二铵, 趋化因子, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of standard immunosuppressive therapy with combination of diammonium glycyrrhizinate in the treatment of patients with autoimmune hepatitis (AIH). Methods 64 patients with AIH were enrolled in our hospital between October 2022 and October 2024, and were randomly assigned to receive standard immunosuppressive therapy in 32 cases for control, or to receive diammonium glycyrrhizinate at base of standard immunosuppressive therapy in another 32 cases in observation, for six months. Serum immunoglobulin G (IgG), IgA and IgM levels were detected by immunoturbidimetry, and serum hyaluronic acid (HA), laminin (LN), type III procollagen (PCIII) and type IV collagen (IV-C) levels were measured by radioimmunoassay. Serum chemokine C-C-motif ligand 2 (CCL2), CCL4, chemokine ligand 8 (CXCL-8) and CXCL10 levels were detected by ELISA. Results By the end of 6 month treatment, serum ALT, AST and ALP levels in the observation group were (48.2±10.4)U/L, (45.4±8.6)U/L and (66.2±5.4)U/L, all significantly lower than [(76.3±13.8)U/L, (71.6±12.6)U/L and (86.8±7.2)U/L, respectively, P<0.05] in the control; serum IgG, IgA and IgM levels were (13.2±2.4)g/L, (2.0±0.4)g/L and (2.6±0.5)g/L, all much lower than [(16.8±2.6)g/L, (2.8±0.6)g/L and (3.7±0.7)g/L, P<0.05] in the control group; serum HA and PCⅢ levels were (113.2±42.6)μg/L and (94.6±37.9)μg/L, both much lower than [(174.8±49.2)μg/L and (132.1±42.6)μg/L, P<0.05] in the control; serum CCL2, CCL4, CXCL-8 and CXCL10 levels were (54.2±5.6)ng/L, (156.8±29.4)ng/L, (21.9±4.2)ng/L and (20.9±3.7)ng/L, all significantly lower than [(60.4±6.2)ng/L, (181.7±24.3)ng/L, (26.5±4.6)ng/L and (27.6±4.9)ng/L, respectively, P<0.05] in the control group. Conclusion Standard immunosuppressive therapy plus oral diammonium glycyrrhizinate has an excellent efficacy in the treatment of patients with AIH, which might be related to further relief of body inflammatory reaction.

Key words: Autoimmune hepatitis, Standard immunosuppressive therapy, Diammonium glycyrrhizinate, Chemokines, Therapy