硫普罗宁联合美他多辛治疗酒精性肝病患者疗效初步研究*

doi:10.3969/j.issn.1672-5069.2020.01.016

摘要/Abstract

摘要： 目的探讨应用硫普罗宁联合美他多辛治疗酒精性肝病(ALD)患者的疗效。方法将76例ALD患者随机分为对照组38和联合组38例,分别给予硫普罗宁或硫普罗宁联合美他多辛口服治疗3个月。采用放射免疫法检测血清IV型胶原(IV-C)、透明质酸(HA)和层粘连蛋白(LN),使用美国贝克曼-库尔特有限公司生产的DX-800型全自动生化分析仪检测血生化指标,使用彩色多普勒超声诊断仪检测门静脉内径(PVD)、脾静脉内径(SVD)和脾厚度。结果治疗后,联合组患者血清IV-C、HA和LN水平分别为(84.3±24.7) μg/L、(142.6±46.8) μg/L和(134.4±35.2)μg/L,显著低于对照组【分别为(142.2±29.3) μg/L、(186.4±40.5) μg/L和(190.5±47.3) μg/L,P<0.05】;联合组丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转肽酶和碱性磷酸酶水平分别为【(42.6±12.3) U/L、(41.3±11.8) U/L、(119.3±55.6) U/L和(91.3±37.8) U/L,显著低于对照组患者【分别为(70.4±20.1) U/L、(75.2±14.9) U/L、(180.4±77.8) U/L和 (130.5±43.6) U/L,P<0.05】;联合组患者PVD、SVD和脾厚度分别为(11.8±1.1) mm、 (6.3±1.2) mm和(54.3±10.7) mm,其中后两者显著小于对照组患者【分别为(12.9±1.4) mm、(7.9±1.3) mm和(61.9±11.6) mm,P<0.05】;治疗后,联合组轻度、中度和重度脂肪肝构成比分别为7.9%、15.8%和7.9%,显著低于对照组(分别为18.4%、31.6%和13.2%,P<0.05)。结论应用硫普罗宁联合美他多辛治疗ALD患者能有效降低血清肝纤维化指标,减轻脂肪肝和纤维化程度,从而有效改善肝功能指标。

关键词: 酒精性肝病, 硫普罗宁, 美他多辛, 肝纤维化, 治疗

Abstract: Objective The aim of this study was to explore the efficacy of tiopronin and metoprolol combination in treatment of patients with alcoholic liver disease (ALD). Methods 76 patients with ALD were recruited in our hospital, and were randomly divided into control (n=38) and observation group (n=38). The patients in both groups were treated with tiopronin orally, and those in the observation group were additionally treated with metoprolol. The treatment lasted for three months. Serum levels of liver fibrosis index, liver function index, portal vein diameter(PVD), spleen vein diameter(SVD) and spleen thickness as well as fatty liver were compared between the two groups. Results At the end of the treatment, serum type IV collagen, hyaluronic acid and laminin levels in the observation group were (84.3±24.7) μg/L, (142.6±46.8) μg/L and (134.4±35.2) μg/L, significantly lower than in the control; serum alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase and alkaline phosphatase levels were [(42.6±12.3) U/L, (41.3±11.8) U/L, (119.3±55.6) U/L and (91.3±37.8) U/L, significantly lower than in the control; the PVD, SVD and spleen thickness in the observation group were (11.8±1.1) mm, (6.3±1.2) mm and (54.3±10.7) mm, significantly lower than in the control; the percentages of mild, moderate and severe fatty liver in the observation group were 7.9%, 15.8% and 7.9%, significantly lower than 18.4%, 31.6% and 13.2% in the control (P<0.05). Conclusion The combination of tiopronin and metoprolol in the treatment of patients with ALD is efficacious with reduced serum level of liver enzymes and liver fibrosis index, and the possible mechanism by which the regimen work might be related to the inhibition of liver fibrosis.

Key words: Alcoholic liver disease, Tiopronin, Metadoxine, Liver fibrosis, Therapy

孙红菊, 王衍颜, 徐丛聪, 赵红. 硫普罗宁联合美他多辛治疗酒精性肝病患者疗效初步研究^*[J]. 实用肝脏病杂志, 2020, 23(1): 54-57.

Sun Hongju, Wang Yanyan, Xu Congcong, et al. Efficacy of tiopronin and metoprolol combination in treatment of patients with alcoholic liver disease[J]. Journal of Practical Hepatology, 2020, 23(1): 54-57.

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硫普罗宁联合美他多辛治疗酒精性肝病患者疗效初步研究^*

Efficacy of tiopronin and metoprolol combination in treatment of patients with alcoholic liver disease

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