多烯磷脂酰胆碱对乙肝肝硬化肝纤维化进程及预后的影响研究

Effects of polyene phosphatidylcholine on the progression and prognosis of hepatic fibrosis in hepatitis B cirrhosis

摘要:

目的 观察多烯磷脂酰胆碱对乙肝肝硬化患者肝纤维化进程及预后情况的影响。方法 该研究为前瞻性研究，选择河南科技大学第一附属医院2021年6月至2023年7月收治的101例乙肝肝硬化患者为研究对象，采用计算机随机分组法将其列为常规组（50例）和试验组（51例），常规组实施常规药物治疗，试验组采用多烯磷脂酰胆碱配合治疗，比较两组患者的病毒载量水平、肝纤维化指标、肝功能指标、炎症指标改善情况，及预后情况。结果 试验组治疗1个月、2个月、3个月后的病毒载量水平分别为（5.25±1.36）×10⁵ copies/mL、（3.36±0.42）×10⁵ copies/mL、（1.04±0.35）×10⁵ copies/mL，均低于常规组［（6.33±1.75）×10⁵ copies/mL、（4.15±1.77）×10⁵ copies/mL、（2.24±0.82）×10⁵ copies/mL］（P<0.05）；试验组治疗后的透明质酸（HA）、层黏连蛋白（LN）、Ⅲ前胶原（PCⅢ）分别为（90.25±10.65）ng/mL、（75.22±10.36）ng/mL、（105.35±20.71）ng/mL，均低于常规组［（95.44±10.28）ng/mL、（80.33±10.49）ng/mL、（120.36±20.57）ng/mL］（P<0.05）；试验组治疗后的总胆红素（TBiL）、谷丙转氨酶（GPT）、谷草转氨酶（GOT）分别为（40.46±10.25）μmol/L、（50.25±10.61）U/L、（51.48±10.37）U/L，均低于常规组［（45.61±10.23）μmol/L、（55.82±10.31）U/L、（56.72±10.24）U/L］（P<0.05）；试验组治疗后的白细胞计数（WBC）、中性粒细胞计数（NE）、淋巴细胞计数（LYM）分别为（8.44±1.27）×10⁹/L、（7.65±1.38）×10⁹/L、（3.44±0.52）×10⁹/L，均低于常规组［（10.62±2.35）×10⁹/L、（8.77±1.95）×10⁹/L、（4.24±1.79）×10⁹/L］（P<0.05）；试验组的不良预后发生率［9.80%（5/51）］低于常规组［24.00%（12/50）］（P<0.05）。结论 多烯磷脂酰胆碱能有效降低乙肝肝硬化患者的病毒载量水平，对抑制其肝纤维化进程、减轻肝功能损伤、缓解炎症反应并改善预后情况均有积极意义。

Abstract:

Objective To observe the effect of polyene phosphatidylcholine on the progression and prognosis of liver fibrosis in patients with hepatitis B cirrhosis.Methods This study is a prospective study. A total of 101 patients with hepatitis B cirrhosis who were admitted from June 2021 to July 2023 were selected as the study objects. They were randomly divided into the conventional group (50 cases) and the experimental group (51 cases) by computer. The conventional group was treated with conventional drugs, and the experimental group was treated with polyene phosphatidylcholine. The improvement of viral load level, liver fibrosis indicators, liver function indicators, inflammatory indicators and prognosis were compared between the two groups.Results Under different treatment plans, the viral load levels of the experimental group after 1 month, 2 months, and 3 months of treatment were (5.25±1.36)×10⁵ copies/mL, (3.36±0.42)×10⁵ copies/mL, (1.04±0.35)×10⁵ copies/mL, lower than the conventional group [(6.33±1.75)×10⁵ copies/mL, (4.15±1.77)×10⁵ copies/mL, (2.24±0.82)×10⁵ copies/mL] (P<0.05). After treatment the HA, LN, and PC III of the experimental group were 90.25±10.65 ng/mL, 75.22±10.36 ng/mL, and 105.35±20.71 ng/mL, lower than the conventional group (95.44±10.28 ng/mL, 80.33±10.49 ng/mL, and 120.36±20.57 ng/mL) (P<0.05). After treatment, the TBiL, GPT, and GOT of the experimental group (40.46±10.25 μmol/L, 50.25±10.61 U/L, and 51.48±10.37 U/L) were all lower than those in the conventional group (45.61±10.23 μmol/L, 55.82±10.31 U/L, 56.72±10.24 U/L) (P<0.05). After treatment, the WBC, NE, and LYM of the experimental group were (8.44±1.27)×10⁹/L, (7.65±1.38)×10⁹/L, (3.44±0.52)×10⁹/L, lower than the conventional group [(10.62±2.35)×10⁹/L, (8.77±1.95)×10⁹/L, (4.24±1.79)×10⁹/L] (P<0.05). The incidence of poor prognosis in the experimental group was 9.80% (5/51), lower than that in the conventional group [24.00% (12/50)] (P<0.05).Conclusion Polyene phosphatidylcholine can effectively reduce the level of viral load in patients with hepatitis B cirrhosis, which has positive significance in inhibiting the process of liver fibrosis, alleviating liver function damage, alleviating inflammatory reaction and improving the prognosis.