前列地尔联合吡喹酮治疗血吸虫性肝纤维化的疗效观察
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摘要
目的:观察前列地尔联合吡喹酮治疗血吸虫性肝纤维化的疗效。方法:选取2016年8月-2017年12月在本院血吸虫病专科门诊就诊或住院的血吸虫性肝纤维化患者102例,按照随机数字表法分成对照组和治疗组,各51例。对照组患者采用吡喹酮治疗,治疗组患者采用吡喹酮联合前列地尔治疗,分析两组患者治疗后肝功能、血清肝纤维化指标水平变化情况。结果:治疗组患者粪便虫卵转阴率为90.20%,对照组为86.27%,两组比较差异无统计学意义(P>0.05)。治疗前,两组患者ALT、AST、TBil、A/G比值水平比较,差异均无统计学意义(P>0.05);治疗后,治疗组患者A/G比值高于对照组,ALT、AST、TBil水平均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者血清肝纤维化4项指标水平及Child-Pugh评分比较,差异均无统计学意义(P>0.05);治疗后,治疗组患者Ⅳ-C、PC-Ⅲ、HA、LN水平及Child-Pugh评分均低于对照组,差异均有统计学意义(P<0.05)。结论:前列地尔联合吡喹酮治疗血吸虫性肝纤维化可促进粪便虫卵转阴,改善患者肝脏功能,减轻患者肝脏纤维化。
Objective:To observe the therapeutic effect of Alprostadil combined with Praziquantel on schistosomiasis hepatic fibrosis.Method:From August 2016 to December 2017,102 patients with schistosomiasis hepatic fibrosis were selected,they were randomly divided into control group and treatment group,according to the random table method,51 cases in each group.The patients in the control group were treated with Praziquantel,the patients in the treatment group were treated with Praziquantel combined with Alprostadil.The changes of liver function,serum liver fibrosis indexes after treatment were analyzed.Result:The negative rate of fecal eggs was 90.20% in the treatment group,and 86.27% in the control group,there was no significant difference between the two groups(P>0.05).Before treatment,the levels of ALT,AST,TBil,A/G ratio were compared between the two groups,and the differences were not statistically significant(P>0.05);after treatment,the A/G ratio in the treatment group was higher than that in the control group,and the ALT,AST,TBil level were lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,the 4 indicators of serum liver fibrosis and Child-Pugh score of the two groups were compared,the differences were not statistically significant(P>0.05);after treatment,the levels of Ⅳ-C,PC-Ⅲ,HA,LN and Child-Pugh score in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Alprostadil combined with Praziquantel in the treatment of schistosomiasis hepatic fibrosis can improve the liver function of patients with schistosomiasis liver fibrosis.
Objective:To observe the therapeutic effect of Alprostadil combined with Praziquantel on schistosomiasis hepatic fibrosis.Method:From August 2016 to December 2017,102 patients with schistosomiasis hepatic fibrosis were selected,they were randomly divided into control group and treatment group,according to the random table method,51 cases in each group.The patients in the control group were treated with Praziquantel,the patients in the treatment group were treated with Praziquantel combined with Alprostadil.The changes of liver function,serum liver fibrosis indexes after treatment were analyzed.Result:The negative rate of fecal eggs was 90.20% in the treatment group,and 86.27% in the control group,there was no significant difference between the two groups(P>0.05).Before treatment,the levels of ALT,AST,TBil,A/G ratio were compared between the two groups,and the differences were not statistically significant(P>0.05);after treatment,the A/G ratio in the treatment group was higher than that in the control group,and the ALT,AST,TBil level were lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,the 4 indicators of serum liver fibrosis and Child-Pugh score of the two groups were compared,the differences were not statistically significant(P>0.05);after treatment,the levels of Ⅳ-C,PC-Ⅲ,HA,LN and Child-Pugh score in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Alprostadil combined with Praziquantel in the treatment of schistosomiasis hepatic fibrosis can improve the liver function of patients with schistosomiasis liver fibrosis.
引文
[1]徐倩,黄海.丹参酮ⅡA磺酸钠治疗日本血吸虫病肝纤维化的长期效果[J].中国热带医学,2016,16(12):1216-1219.
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[4]廖红保,沈明.多次吡喹酮治疗抗血吸虫病肝纤维化疗效观察[J].中国血吸虫病防治杂志,2017,29(2):241-242.
[5]廖世业,李军俊,熊丽娟.亚临床型血吸虫病患者病原治疗前后血清γ-谷氨酰转肽酶水平观察[J].中国血吸虫病防治杂志,2016,28(5):596-597.
[6]赵晋英,李艳伟,汪世平.血吸虫铁代谢的研究进展[J].中国寄生虫学与寄生虫病杂志,2017,35(4):407-411.
[7]杨海峰,李勇军,陆广富,等.吡喹酮注射液对水牛血吸虫病的临床治疗效果[J].中国畜牧兽医,2017,44(5):1552-1556.
[8]Wami W M,Nausch N,Midzi N,et al.Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children[J].Biomed Research International,2016,2016(2):9162631.
[9]钱科,梁幼生,汪伟,等.血吸虫对吡喹酮抗药性的研究(ⅩⅦ)日本血吸虫吡喹酮抗性株在小鼠体内的生物学特性[J].中国血吸虫病防治杂志,2017,29(6):683-688.
[10]张玉梅,王燕娟,刘华,等.吡喹酮治疗后日本血吸虫感染小鼠滤泡辅助性T细胞及其表面分子的研究[J].中国寄生虫学与寄生虫病杂志,2016,34(2):99-104.
[11]刘西霞,黄政德,卢芳国,等.抗纤灵Ⅰ方对小鼠血吸虫病肝纤维化的干预及机制探讨[J].湖南中医药大学学报,2016,36(10):11-17.
[12]Sanchez M C,Krasnec K V,Parra A S,et al.Effect of praziquantel on the differential expression of mouse hepatic genes and parasite ATP binding cassette transporter gene family members during Schistosoma mansoni infection[J].PLoS Negl Trop Dis,2017,11(6):e0005691.
[13]来如意,郑娜,彭妮娜,等.BILT与吡喹酮联用对日本血吸虫病患者治疗和护理的效果[J].中国血吸虫病防治杂志,2017,29(5):648-650.
[14]Ru-Yi L,Na Z,Ni-Na P,et al.Therapeutic effect of BILT combined with praziquantel in treatment of chronic schistosomiasis[J].Chinese Journal of Schistosomiasis Control,2017,29(5):648.
[15]Senghor B,Diaw O T,Doucoure S,et al.Impact of Annual Praziquantel Treatment on Urogenital Schistosomiasis in a Seasonal Transmission Focus in Central Senegal[J].Plos Negl Trop Dis,2016,10(3):e0004557.
[16]Li H R,Li G,Li M,et al.Corilagin ameliorates schistosomiasis hepatic fibrosis through regulating IL-13 associated signal pathway in vitro and in vivo[J].Parasitology,2016,143(12):1629-1638.
[17]李小林,程伟宁,黄龙虎,等.前列地尔联合依达拉奉对冠心病患者心肌微循环及血液流变学的改变与疗效分析[J].中国临床医生杂志,2017,45(11):36-38.
[18]骆中华,吕飞.小檗碱联合吡喹酮对大鼠日本血吸虫病肝纤维化组织MMP-13与TIMP-1表达的影响[J].医药导报,2016,35(1):39-43.
[2]张伟伟,朱继峰,王任,等.白藜芦醇调控Th1和Th2应答抑制小鼠日本血吸虫病肝脏纤维化的研究[J].中国药理学通报,2016,32(8):1091-1097.
[3]邓菊红,陶然,焦云桃,等.热休克蛋白47在日本血吸虫病肝纤维化病程的动态变化[J].传染病信息,2017,30(3):156-160.
[4]廖红保,沈明.多次吡喹酮治疗抗血吸虫病肝纤维化疗效观察[J].中国血吸虫病防治杂志,2017,29(2):241-242.
[5]廖世业,李军俊,熊丽娟.亚临床型血吸虫病患者病原治疗前后血清γ-谷氨酰转肽酶水平观察[J].中国血吸虫病防治杂志,2016,28(5):596-597.
[6]赵晋英,李艳伟,汪世平.血吸虫铁代谢的研究进展[J].中国寄生虫学与寄生虫病杂志,2017,35(4):407-411.
[7]杨海峰,李勇军,陆广富,等.吡喹酮注射液对水牛血吸虫病的临床治疗效果[J].中国畜牧兽医,2017,44(5):1552-1556.
[8]Wami W M,Nausch N,Midzi N,et al.Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children[J].Biomed Research International,2016,2016(2):9162631.
[9]钱科,梁幼生,汪伟,等.血吸虫对吡喹酮抗药性的研究(ⅩⅦ)日本血吸虫吡喹酮抗性株在小鼠体内的生物学特性[J].中国血吸虫病防治杂志,2017,29(6):683-688.
[10]张玉梅,王燕娟,刘华,等.吡喹酮治疗后日本血吸虫感染小鼠滤泡辅助性T细胞及其表面分子的研究[J].中国寄生虫学与寄生虫病杂志,2016,34(2):99-104.
[11]刘西霞,黄政德,卢芳国,等.抗纤灵Ⅰ方对小鼠血吸虫病肝纤维化的干预及机制探讨[J].湖南中医药大学学报,2016,36(10):11-17.
[12]Sanchez M C,Krasnec K V,Parra A S,et al.Effect of praziquantel on the differential expression of mouse hepatic genes and parasite ATP binding cassette transporter gene family members during Schistosoma mansoni infection[J].PLoS Negl Trop Dis,2017,11(6):e0005691.
[13]来如意,郑娜,彭妮娜,等.BILT与吡喹酮联用对日本血吸虫病患者治疗和护理的效果[J].中国血吸虫病防治杂志,2017,29(5):648-650.
[14]Ru-Yi L,Na Z,Ni-Na P,et al.Therapeutic effect of BILT combined with praziquantel in treatment of chronic schistosomiasis[J].Chinese Journal of Schistosomiasis Control,2017,29(5):648.
[15]Senghor B,Diaw O T,Doucoure S,et al.Impact of Annual Praziquantel Treatment on Urogenital Schistosomiasis in a Seasonal Transmission Focus in Central Senegal[J].Plos Negl Trop Dis,2016,10(3):e0004557.
[16]Li H R,Li G,Li M,et al.Corilagin ameliorates schistosomiasis hepatic fibrosis through regulating IL-13 associated signal pathway in vitro and in vivo[J].Parasitology,2016,143(12):1629-1638.
[17]李小林,程伟宁,黄龙虎,等.前列地尔联合依达拉奉对冠心病患者心肌微循环及血液流变学的改变与疗效分析[J].中国临床医生杂志,2017,45(11):36-38.
[18]骆中华,吕飞.小檗碱联合吡喹酮对大鼠日本血吸虫病肝纤维化组织MMP-13与TIMP-1表达的影响[J].医药导报,2016,35(1):39-43.