异甘草酸镁治疗自身免疫性肝炎患者血清细胞因子水平变化*

doi:10.3969/j.issn.1672-5069.2023.02.016

摘要/Abstract

摘要： 目的探讨应用异甘草酸镁注射液治疗自身免疫性肝炎(AIH)患者血清细胞因子水平变化。方法 2019年8月～2021年8月我院诊治的46例AIH患者被随机分为观察组23例和对照组23例,常规给予两组泼尼松治疗并适时逐渐减量维持。在观察组,另给予异甘草酸镁注射液治疗8周。采用ELISA法测定血清白细胞介素18(IL-18)、IL-2、肿瘤坏死因子-α(TNF-α)水平,采用硝酸还原酶法测定血清一氧化氮(NO)水平,采用放射免疫法测定血清层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(Ⅳ-C)水平。结果在治疗8周末,观察组血清ALT、AST和TBIL水平分别为(44.3±7.3)U/L、(38.5±6.4)U/L和(25.2±5.2)μmmol/L,均显著低于对照组【分别为(69.8±11.3)U/L、(46.5±7.3)U/L和(31.6±6.4)μmmol/L,P<0.05】;观察组血清IL-18和TNF-α水平分别为(36.3±6.3)pg/mL和(27.1±4.4)pg/mL,显著低于对照组【分别为(42.5±7.4)pg/mL和(35.5±5.9)pg/mL,P<0.05】,而血清NO和IL-2水平分别为(47.3±7.1)μmmol/L和(464.3±65.2)pg/mL,均显著高于对照组【分别为(41.8±8.1)μmmol/L和(419.8±74.1)pg/mL,P<0.05】;观察组血清HA、PCⅢ和Ⅳ-C水平分别为(131.7±22.5)μg/L、(133.9±22.6)μg/L和(126.9±19.8)μg/L,均显著低于对照组【分别为(184.4±28.4)μg/L、(167.4±28.1)μg/L和(158.6±24.6)μg/L,P<0.05】。结论应用异甘草酸镁注射液治疗AIH患者能够改善肝功能,减轻肝损伤,缓解肝纤维化,其长期疗效还需要观察。

关键词: 自身免疫性肝炎, 异甘草酸镁, 细胞因子, 治疗

Abstract: Objective The purpose of this study was to investigate the efficacy of magnesium isoglycyrrhizinate in the treatment of patients with autoimmune hepatitis (AIH) and the effects on serum cytokine changes. Methods 46 patients with AIH were admitted to the Nantong Cancer Hospital between August 2019 and August 2021, and were randomly divided into two groups, with 23 cases in each. The prednisone was routinely given to all the patients in the two groups, and the dose was gradually tapered to maintaining. The magnesium isoglycyrrhizinate was intravenously administered in patients in observation group for 8 weeks. Serum interleukin 18 (IL-18), IL-2 and tumor necrosis factor alpha (TNF-α) levels were assayed by enzyme-linked immunosorbent assay, serum nitric oxide (NO) level was detected by nitrate reductase method, and serum laminin (LN), hyaluronic acid (HA), type III procollagen (PCIII) and type IV collagen (IV-C) levels were determined by radioimmunoassay. Results At the end of eight week treatment, serum ALT, AST and bilirubin levels in the observation group were (44.3±7.3)U/L, (38.5±6.4)U/L and (25.2±5.2)μmmol/L, all significantly lower than [(69.8±11.3)U/L, (46.5±7.3)U/L and (31.6±6.4)μmmol/L, respectively, P<0.05] in the control; serum IL-18 and TNF-α levels were (36.3±6.3)pg/mL and (27.1±4.4)pg/mL, both significantly lower than [(42.5±7.4)pg/mL and (35.5±5.9)pg/mL, respectively, P<0.05], while serum NO and IL-2 levels were (47.3±7.1)μmmol/L and (464.3±65.2)pg/mL, both significantly higher than [(41.8±8.1)μmmol/L and (419.8±74.1)pg/mL, respectively, P<0.05] in the control; serum HA, PCⅢ and Ⅳ-C levels were (131.7±22.5)μg/L, (133.9±22.6)μg/L and (126.9±19.8)μg/L, all significantly lower than [(184.4±28.4)μg/L, (167.4±28.1)μg/L and (158.6±24.6)μg/L, respectively, P<0.05] in the control. Conclusion The administration of magnesium isoglycyrrhizinate in the treatment of patients with AIH could short-termly improve liver function test normalization and relieve liver fibrosis, which needs further clinical investigation.

Key words: Autoimmune hepatitis, Magnesium isoglycyrrhizinate, Cytokines, Therapy

凌佳慧, 倪美鑫, 韩黎黎, 卫栋萍, 戴轶伟, 陈婷婷. 异甘草酸镁治疗自身免疫性肝炎患者血清细胞因子水平变化^*[J]. 实用肝脏病杂志, 2023, 26(2): 214-217.

Ling Jiahui, Ni Meixin, Han Lili, et al.. Serum cytokine changes in patients with autoimmune hepatitis receiving magnesium isoglycyrrhizinate treatment[J]. Journal of Practical Hepatology, 2023, 26(2): 214-217.

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异甘草酸镁治疗自身免疫性肝炎患者血清细胞因子水平变化^*

Serum cytokine changes in patients with autoimmune hepatitis receiving magnesium isoglycyrrhizinate treatment

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