摘要
目的探讨部分脾动脉栓塞术(PSE)联合胸腺五肽对乙型肝炎(乙肝)肝硬化脾功能亢进患者细胞免疫、肝纤维化标记物和肝脏硬度值(LSM)的改善作用。方法选取84例乙肝肝硬化脾功能亢进患者,采用随机数字法分为对照组(n=42)和观察组(n=42)。均行PSE术,术后对照组予以护肝、抗感染、抗病毒及对症支持治疗,观察组在此基础上另予以胸腺五肽肌内注射,疗程24周。6个月后比较两组外周血淋巴细胞亚群(CD^(3+)、CD^(4+)、CD^(8+)、CD^(4+)/CD^(8+))、血清肝纤维化标记物[层粘连蛋白(LN)、Ⅳ型胶原(C-Ⅳ)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)]水平及LSM(肝脏超声瞬时弹性成像测定)变化。结果6个月后,两组CD^(3+)、CD^(4+)计数百分率和CD^(4+)/CD^(8+)比率较治疗前显著升高(P<0.05),CD^(8+)计数百分率较治疗前显著降低(P<0.05),而观察组CD^(3+)、CD^(4+)计数百分率和CD^(4+)/CD^(8+)比率显著高于对照组(P<0.05),CD8+计数百分率显著低于对照组(P<0.05);两组LN、C-Ⅳ、HA、PCⅢ水平均较治疗前显著降低(P<0.05),而观察组均显著低于对照组(P<0.05);对照组LSM较治疗前无显著降低(P>0.05),观察组LSM显著低于治疗前(P<0.05),且低于对照组(P<0.05)。结论乙肝肝硬化脾功能亢进患者PSE术后使用胸腺五肽可改善细胞免疫功能,降低肝纤维化标记物水平,降低肝脏硬度,综合疗效优于单独PSE,具有较好的临床推广价值。
Objective To explore the efficacy of partial splenic artery embolization(PSE)combined with thymopentin in improving cellular immunity,liver fibrosis markers and liver stiffness measurement(LSM)in patients with post-hepatitis B cirrhotic hypersplenism.Methods A total of 84 patients with post-hepatitis B cirrhotic hypersplenism were enrolled in this study.By using random digital method,the patients were divided into control group(n=42)and observation group(n=42).PSE was performed in all patients of both groups.After PSE,the therapies,including liver protection,anti-infection,anti-virus and symptomatic and supportive treatment,were employed for the patients of the control group,and on the basis of which the patients of the observation group received additional intramuscular injection of thymopentin with a treatment course of 24weeks.The postoperative 6-month levels of the peripheral blood lymphocyte subsets(CD^(3+),CD^(4+),CD^(8+),CD^(4+)/CD^(8+)),serum liver fibrosis markers including laminin(LN),type IV collagen(C-IV),hyaluronic acid(HA)and typeⅢpre-collagen(PCⅢ),and LSM(determined by liver ultrasound transient elastography)were compared between the two groups.Results Six months after treatment,in both groups the percentages of CD^(3+),CD^(4+)lymphocytes and the ratio of CD^(4+)/CD^(8+)were significantly higher than their preoperative values(P0.05),while the percentage of CD^(8+)lymphocytes was remarkably lower than its preoperative value(P0.05);the percentages of CD^(3+),CD^(4+)lymphocytes and the ratio of CD^(4+)/CD^(8+)in the observation group were obviously higher than those in the control group(P<0.05),while the percentage of CD^(8+)lymphocytes was prominently lower than that in the control group(P<0.05).The postoperative levels of LN,C-IV and PCⅢin both groups were strikingly lower than their preoperative values(P<0.05),and the postoperative levels of LN,C-IV and PCⅢin the observation group were notably lower than those in the control group(P<0.05).The postoperative LSM in the control group was not s
作者
范辉
王富兵
丁江涛
王小乐
石红建
魏怡然
FAN Hui;WANG Fubing;DING Jiangtao;WANG Xiaole;SHI Hongjian;WEI Yiran(Department of Gastroenterology,Afiliated Rehabilitation Hospital of Nantong University,Nantong,Jiangsu Province 226002,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第9期905-908,共4页
Journal of Interventional Radiology
基金
国家自然科学基金青年基金(82000532)。
关键词
肝硬化
胸腺五肽
部分脾动脉栓塞
细胞免疫
cirrhosis
thymopentin
partial splenic artery embolization
cellular immunity
