摘要
目的探讨前列地尔与水飞蓟宾联合用药治疗老年肝硬化病人的临床疗效及对病人纤维化指标、炎症因子水平的影响。方法选取2015年12月至2017年5月我院收治的年龄>60岁的肝硬化老年病人90例,按照随机数字表法分为对照组与观察组,每组各45例。对照组在常规治疗基础上给予前列地尔治疗,观察组在对照组治疗基础上给予水飞蓟宾治疗。检测治疗前后对2组病人肝脏酶学指标、纤维化指标及炎症因子水平进行比较分析,并比较2组治疗后的临床疗效。结果观察组临床疗效明显优于对照组(P<0. 05)。治疗后2组病人血清中丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰基转移酶(GGT)、层粘连蛋白(LN)、透明质酸酶(HA)、Ⅲ型前胶原(PC-Ⅲ)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子α(TNF-α)水平均明显降低;且观察组下调趋势较对照组明显,差异均有统计学意义(P<0. 05)。结论前列地尔与水飞蓟宾联合用药对老年肝硬化具有较好的临床疗效,可明显恢复病人肝功能,改善病人纤维化情况,并缓解炎症状态。
Objective To investigate the clinical efficacy of alprostadil combined with silybin in the treatment of the elderly patients with cirrhosis and the influence on liver fibrosis index and inflammatory factors. Methods A total of 90 patients with cirrhosis aged over 60 years old admitted to our hospital from December 2015 to May 2017 were randomly divided into control group and observation group,with 45 cases in each group. The control group was treated with alprostadil on the basis of routine treatment,and the observation group was treated with silybin on the basis of the control group. The clinical efficacy and liver function index such as alanine aminotrans ferase( ALT),aspartale amino transferase( AST),gamma-glutamyyl transferase( GGT) after treatment were compared between the two groups. The levels of serum laminin( LN),hyaluronidase( HA),procollagen Ⅲ( PC-Ⅲ),interleukin 6( IL-6),high-sensitivity C-reactive protein( hs-CRP) and tumor necrosis factor α( TNF-α) were detected and compared between the two groups before and after treatment. Results After treatment,the clinical efficacy of the observation group was better than that of the control group( P<0. 05). After treatment,the serum levels of ALT,AST,GGT,LN,HA,PC-Ⅲ,IL-6,hs-CRP and TNF-α in the two groups were significantly decreased,especially in the observation group( P< 0. 05). Conclusions The combination of alprostadil and silibinin has a good clinical effect on elderly patients with cirrhosis. It can obviously restore the liver function,improve the fibrosis and relieve the inflammatory state of the patients.
作者
蒯星宇
向正国
郑扬
陈旭峰
李科军
KUAI Xing-yu;CHEN Xu-feng;LI Ke-jun;XIANG Zheng-guo;ZHENG Yang(Department of Gastroenterology,Taihu Hospital of Wuxi,Wuxi 214000,China)
出处
《实用老年医学》
CAS
2019年第2期186-189,共4页
Practical Geriatrics
