Abstract: Objective The purpose of this study was to investigate the clinical efficacy of N-acetylcysteine (NAC) in the treatment of patients with chronic icteric hepatitis B. Methods A total of 62 patients with chronic hepatitis B (CHB) and hyperbilirubinemia were recruited in our hospital between January 2015 and December 2018, and they were randomly divided into observation (n=32) and control group (n=30). The patients in the control group were treated with comprehensive supporting treatment, such as liver protection, jaundice reduction, immune regulation and anti-viral therapy, and the patients in the observation group were treated with intravenous infusion of NAC at dose of 8.0 g daily on the basis of treatment in the control group for six weeks. Serum Ⅲ type collagen (PC-Ⅲ), type IV collagen (IV-C), hyaluronic acid (HA), laminin (LN)] levels were detected by radioimmunoassay, and serum interleukin-1 beta(IL-1β), IL-6, IL-8 and tumor necrosis factor alpha (TNF-α)] were assayed by ELISA. Results At the end of six week treatment, serum ALT and AST levels in the observation group were (45.4±2.9) U/L and (74.3±8.7) U/L, not significantly different as compared to , while total serum bilirubin level were (85.1±54.6)μmol/L, much lower than in the control; serum PC-Ⅲ, IV-C, HA and LN levels were (87.1±15.8)μg/L,(74.5±15.2)μg/L, (95.7±13.7)μg/L and (83.9±16.5)μg/L, significantly lower than in the control; serum IL-6, IL-8 and TNF-α levels were (15.1±2.8)μg/L, (5.2±2.9)μg/L and (13.7±0.9) μg/L, significantly lower than in the control; the disease control rate in the observation was 87.1%, much higher than 64.3% (P<0.05) in the control. Conclusion The application of NAC in the treatment of patients with chronic icteric hepatitis B is efficacious and safe, which might decrease serum bilirubin levels and alleviate liver fibrosis.

Key words: Hepatitis B, Hyperbilirubinemia, N-acetylcysteine, Cytokines, Therapy