氧化苦参碱治疗慢性乙型肝炎致转氨酶反跳的临床意义及相关因素

张学武; 李旭; 胡国启; 李春玉; 周敏

氧化苦参碱治疗慢性乙型肝炎致转氨酶反跳的临床意义及相关因素

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中图分类号: R512.6
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- 出版日期: 2008-01-20

The clinic significance and correlated factors of Alanine Aminotransferase (ALT) flare in patients with chronic hepatitis B treated with Oxymatrine.

摘要

摘要: 目的探讨氧化苦参碱治疗慢性乙型肝炎过程中致ALT反跳的临床意义及影响因素。方法对96例接受氧化苦参碱治疗过程中出现ALT反跳的慢性乙型肝炎患者的临床资料进行分析,观察ALT反跳的临床意义,分析影响ALT的反跳的因素。结果氧化苦参碱治疗慢性乙型肝炎过程中ALT反跳发生率为22.2%;伴有ALT反跳的患者对治疗的完全应答率和持续应答率均高于未发生ALT反跳者(P=0.0010和P=0.0086);ALT反跳的患者HBVDNA下降幅度高于未发生ALT反跳者(P=0.0002、0.0000);ALT反跳发生率与治疗前的HBVDNA水平呈正相关(P=0.0014);联合拉米夫定治疗能降低ALT的反跳率(27.2%vs 11.6%,P=0.002)。结论氧化苦参碱治疗慢性乙型肝炎过程中可发生ALT反跳,其发生与氧化苦参碱抗病毒的应答反应有关。
- 氧化苦参碱 /
- 乙型肝炎 /
- 丙氨酸氨基转移酶 /
- HBVDNA
Abstract: Objective To explore the clinic significance and correlated factors of alanine aminotransferase (ALT) flare in patients with chronic hepatitis B treated with Oxymatrine.Methods By retrospective analysis, we reviewed the clinic datum of 96 chronic hepatitis B patients treated with Oxymatrine, then observed the relationship between ALT flare and the pretreatment ALT level and HBV DNA level compared with patients treated with lamivudine.Results There were 96 patients received Oxymatrine treatment and ALT flare rate was 22.2%.The complete response rate and sustained response rate were higher in the patients with ALT flare than those with no ALT flare, respectively (P=0.0010 and 0.0086) .The HBV DNA decline scope were higher in the patients with ALT flare than the patients with no ALT flare (P=0.0002;0.0000) .ALT flare rate was positively correlated with pre-treatment serum HBV DNA level, but no correlation with pre-treatment ALT level.Combined treatment with Oxymatrine and lamivudine can reduce the ALT flare rate (11.6% vs 27.2%, P=0.002) .Conclusions There were ALT flare in the patients treated with Oxymatrine, and the ALT flares were associated with antivirus response.
- Oxymatrine /
- hepatitis B /
- ALT /
- HBV DNA

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参考文献(20)

[1]蔡雄, 王国俊, 翟瑶.氧化苦参碱注射液治疗慢性乙型肝炎的临床疗效分析[J].第二军医大学学报, 1997, 18 (1) ∶47-49.

[2]李继强, 陈萦?, 曾民德, 等.氧化苦参碱抗乙肝病毒的体外实验研究[J].中华消化杂志, 2001, 21 (9) ∶550-552.

[3]Dong Y, Xi H, Yu Y, et al.Effects of oxymatrine on the serum lev-els of Thelper cell 1 and 2 cytokines and the expression of the S genein hepatitis B virus S gene transgenic mice:a study on the anti-hep-atitis B virus mechanism of oxymatrine[J].J Gastroenterol Hepatol, 2002, 17 (12) ∶1299-306.

[4]Chen XS, Wang GJ, Cai X, et al.Inhibition of hepatitis B virus byoxymatrine in vivo[J].World J Gastroenterol, 2001, 7 (1) ∶49-52.

[5]Lu LG, Zeng MD, Mao YM, et al.Oxymatrine therapy for chronichepatitis B:A randomized double-blind an placebo-contolledmulti-center trial[J].World J Gastroenterol, 2003, 9 (1) ∶2480-2483.

[6]于岩岩, 斯崇文, 曾争, 等.氧化苦参碱制剂治疗慢性乙型肝炎的临床试验[J].中华内科杂志, 2001, 40 (12) ∶843-846.

[7]于岩岩, 王勤环, 朱理珉, 等.氧化苦参碱治疗慢性乙型肝炎的临床研究[J].中华肝脏病杂志, 2002, 10 (4) ∶280-282.

[8]张学武, 周敏, 胡国启.拉米夫定联合博尔泰力治疗慢性乙型肝炎临床研究[J].临床肝胆病杂志, 2001, 17 (3) ∶165-166.

[9]张学武, 周敏, 胡国启.博尔泰力治疗乙型肝炎活动性肝硬化的临床研究[J].中西医结合肝病杂志, 2002, 12 (3) ∶141-143.

[10]张学武, 周敏, 胡国启.博尔泰力治疗拉米夫定耐药性乙型肝炎的临床研究[J].临床肝胆病杂志, 2003, 19 (2) ∶106-107.

[11]李宝法.氧化苦参碱治疗慢性乙肝远期疗效观察[J].中原医刊, 2004, 31 (17) ∶53-53.

[12]彭杰, 马羽萍, 赵玲, 等.氧化苦参碱注射液治疗慢性乙型肝炎90例临床疗效观察[J].传染病信息, 2000, 13 (4) ∶169.

[13]贾建伟, 杨秋明, 袁桂玉, 等.氧化苦参碱治疗慢性乙型肝炎的疗效及其影响因素探讨[J].中草药, 2003, 34 (11) ∶1030-1031.

[14]王月兰, 徐赛芳, 任慧琼.静脉用氧化苦参碱治疗慢性乙型肝炎[J].东南国防医药, 2004, 6 (6) ∶431-432.

[15]王啸, 董香玉, 朱传安.氧化苦参碱对慢性乙型肝炎外周血T淋巴细胞亚群的影响[J].临床荟萃, 2001, 16 (18) ∶841.

[16]朱莉, 刘晶星.苦参总碱对小鼠脾细胞产生干扰素的影响[J].上海第二医科大学学报.1998, 18 (3) ∶204-206.

[17]Hanns FL, Wolfgang W, Jorg S, et al.Proliferative response of CD+4 Tcells and hepatitis B virus clearence in chronic hepatitis with orwithout hepatitis B e2minus hepatitis B virus mutants[J].Hepatolo-gy, 1995, 22 (1) ∶6126-8.

[18]陈燕熙, 李继强.氧化苦参碱治疗慢性乙型病毒性肝炎疗效及其与HBV负荷的关系探讨[J].中国中西医结合杂志, 2002, 22 (5) ∶335-336.

[19]张学武, 胡国启, 李春玉, 等.氧化苦参碱治疗慢性乙型肝312例[J].世界华人消化杂志, 2005, 13 (3) ∶317-320.

[20]王会贤, 章灵华, 杜守英, 等.氧化苦参碱对淋巴细胞增殖的影响[J].中草药, 1994, 25 (7) ∶362-363.

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