索非布韦/达克拉韦治疗CHC患者血清血管性血友病因子和可溶性血管黏附因子1水平变化*

doi:10.3969/j.issn.1672-5069.2024.06.010

摘要/Abstract

摘要： 目的本研究旨在探讨直接抗病毒药物治疗的慢性丙型肝炎(CHC)患者的疗效及其对血清细胞因子水平的影响。方法 2020年6月～2022年12月我院诊治的38例CHC患者和38例丙型肝炎肝硬化患者,均接受索非布韦(SOF)、盐酸达克拉韦(DCV)和利巴韦林三联疗法治疗12周。采用RT-PCR法检测血清HCV RNA载量,采用ELISA法检测血清血管性血友病因子(vWF)、可溶性血管黏附因子1(sVCAM-1)和白细胞介素-6(IL-6)水平。结果本组丙型肝炎肝硬化患者快速病毒学应答、治疗结束病毒学应答和持续病毒学应答率分别为81.5%、89.5%和97.4%,与CHC组的89.5%、92.1%和100.0%比,无显著性差异(P>0.05);在治疗结束时,肝硬化组外周血白细胞和血小板计数分别为(4.7±0.9)×10⁹/L和(139.5±42.1)×10⁹/L,显著低于CHC组【分别为(6.8±2.2)×10⁹/L和(275.6±65.3)×10⁹/L,P<0.05】,而基于4因子的肝纤维化指数(FIB4)和天冬氨酸氨基转移酶/血小板计数指数(APRI)评分分别为(2.8±1.6)和(0.6±0.3),显著高于CHC组【分别为(0.7±0.9)和(0.2±0.1),P<0.05】;肝硬化组血清vWF和sVCAM-1水平分别(134.3±44.3)ng/mL和(36.6±14.9)ng/mL,显著高于CHC组【分别为(103.9±33.0)ng/mL和(18.7±8.9)ng/mL,P<0.05】。结论应用DAAs治疗HCV感染患者可获得良好的抗病毒疗效,且能有效改善血管内皮功能,其临床意义还有待进一步探讨。

关键词: 肝硬化, 慢性丙型肝炎, 直接抗病毒药物, 血管性血液病因子, 可溶性血管细胞粘附分子-1 , 治疗

Abstract: Objective This study was aimed to investigate serum von Willebrand factor (vWF) and soluble vascular cell adhesion molecule-1 (VACM-1) level changes in patients with hepatitis C viral infection. Methods 38 patients with chronic hepatitis C (CHC) and 38 patients with hepatitis C-induced liver cirrhosis (LC) were enrolled in our hospital between June 2020 and December 2022, and all received sofosbuvir, daclatasvir and ribavirin combination therapy for 12 weeks. Serum HCV RNA loads were detected by RT-PCR, and serum vWF, VACM-1 and interleukin-6 levels were assayed by ELISA. Results The rapid virological response, end treatment of virological response and sustained virological response rates in patient with LC were 81.5%,89.5% and 97.4%, not significantly different as compared to 89.5%, 92.1%and 100.0%in patients with CHC (P>0.05); at the end of antiviral therapy, the white blood cell count and platelet count in patients with LC were(4.7±0.9)×10⁹/L and (139.5±42.1)×10⁹/L, much lower than [(6.8±2.2)×10⁹/L and (275.6±65.3)×10⁹/L, P<0.05], while the FIB-4 and APRI scores were (2.8±1.6) and (0.6±0.3), much higher than [(0.7±0.9) and (0.2±0.1), respectively, P<0.05] in patients with CHC; serum vWF and sVCAM-1 levels in patients with LC were (134.3±44.3)ng/mL and (36.6±14.9)ng/mL, significantly higher than [(103.9±33.0)ng/mL and (18.7±8.9)ng/mL, respectively, P<0.05] in patients with CHC. Conclusion The application of DAAs in treating patients with HCV infection is efficacious, which might improve endothelial function, and needs further study.

Key words: Liver cirrhosis, Hepatitis C, Direct antiviral agents, von Willebrand factor, Soluble vascular cell adhesion molecule-1, Therapy

朱中华, 胡均贤, 李炎. 索非布韦/达克拉韦治疗CHC患者血清血管性血友病因子和可溶性血管黏附因子1水平变化^*[J]. 实用肝脏病杂志, 2024, 27(6): 836-839.

Zhu Zhonghua, Hu Junxian, Li Yan. Serumv on Willebrand factor and soluble vascular cell adhesion molecule-1 level changes in patients with hepatitis C viral infection[J]. Journal of Practical Hepatology, 2024, 27(6): 836-839.

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索非布韦/达克拉韦治疗CHC患者血清血管性血友病因子和可溶性血管黏附因子1水平变化^*

Serumv on Willebrand factor and soluble vascular cell adhesion molecule-1 level changes in patients with hepatitis C viral infection

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