用双环醇治疗的慢性乙型肝炎患者的组织学改善：现实世界

StephenW

Histological improvement in chronic hepatitis B patients treated with bicyclol: real world experience.
Chi X1, Xiao H2, Shi M2,3, Cai G2, Xie Y2, Jiang J2, Tian G2, Wu S2, Zhang C2, Zhao P2, Chen J2.
Author information

1
    Department of Hepatology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Guangzhou, 510120, Guangdong Province, China. [email protected].
2
    Department of Hepatology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Guangzhou, 510120, Guangdong Province, China.
3
    Guangzhou University of Chinese Medicine, Guangzhou, 510403, Guangdong Province, China.

Abstract
BACKGROUND:

Bicyclol, the most commonly-used liver hepatoprotective drug in China, is often selected to control disease progression in CHB patients who refuse anti-viral treatment. However, data on histological changes after bicyclol treatment in these patients are scarce. Therefore, this study has been conducted to find out whether bicyclol has good benefits of histological improvement in CHB patients who refuse anti-viral agents.
METHODS:

The demographic, clinical and pathological data were collected from CHB patients who received bicyclol from January 2010 to June 2016. Improvement in liver inflammation or fibrosis is defined as at least one-grade or one-stage decrease as measured by the Scheuer scoring system. Thirty patients treated with ETV for 48 weeks were chosen as a control group to compare the histological improvement between bicyclol and entecavir (ETV) after 48-week treatment.
RESULTS:

A total of 123 patients with CHB treated with bicyclol were included in this study. Paired liver biopsies were performed in 70 patients. Inter-biopsy interval was 17.44 ± 8.90 months (12-60 months). As shown by facts, 41.4% patients achieved liver inflammation improvement, while only 10.0% patients showed liver inflammation progression after bicyclol treatment. In regarding to liver fibrosis, as shown by facts, 28.6% patients achieved fibrosis improvement. More importantly, It was found that the proportions of patients with liver inflammation and fibrosis improvement were both not significantly lower than those in ETV group (53.3% vs 63.3 and 36.7% vs 43.4%). Most of patients (82.4%) with elevated baseline ALT became normal after bicyclol treatment. More importantly, as shown by the multi-variate analysis, the treatment course of bicyclol was an independent factor for liver inflammation improvement. With the HBeAg status adjusted, ALT and HBV-DNA quantity, the odds ratio (95% confidence interval) of patients with ≥48-week treatment was 5.756 (1.893,17.500) when compared with patients via < 48-week treatment.
CONCLUSION:

Bicyclol can improve liver inflammation and the ALT normalization rate of CHB patients, especially when the treatment course is prolonged. This has confirmed that bicyclol could control hepatitis activity, which might be a good choice for CHB patients who refuse anti-viral treatments.
KEYWORDS:

Bicyclol; Chronic hepatitis B; Hepatoprotective drug; Liver biopsy

PMID:
    31196030
DOI:
    10.1186/s12876-019-1005-1

StephenW

用双环醇治疗的慢性乙型肝炎患者的组织学改善：现实世界的经验。
Chi X1，Xiao H2，Shi M2,3，Cai G2，Xie Y2，Jiang J2，Tian G2，Wu S2，Zhang C2，Zhao P2，Chen J2。
作者信息

1
广东省中医院肝病科，广州中医药大学第二附属医院，广东省大德路111号，广东省广州市510120 [email protected]。
2
广东省中医院肝病科，广州中医药大学第二附属医院，广东省大德路111号，广东省广州市510120
3
广州中医药大学，广东广州510403

抽象
背景：

双环醇是中国最常用的肝脏保肝药物，经常被选用来控制拒绝抗病毒治疗的CHB患者的疾病进展。然而，这些患者在双环醇治疗后组织学变化的数据很少。进行了研究以确定双环醇在拒绝抗病毒药物的CHB患者中是否具有组织学改善的良好益处。
方法：

从2010年1月至2016年6月接受双环醇的CHB患者收集人口统计学，临床和病理学数据。肝脏炎症或纤维化的改善定义为由Scheuer评分系统测量的至少一级或一级降低。选择30名ETV治疗48周的患者作为对照组，比较48周治疗后双环醇和恩替卡韦（ETV）的组织学改善。
结果：

本研究共纳入123名接受双环醇治疗的CHB患者。对70名患者进行了配对肝脏活组织检查。活检间隔为17.44±8.90个月（12-60个月）。如事实所示，41.4％的患者实现肝脏炎症改善，而仅有10.0％的患者在双环醇治疗后显示肝脏炎症进展。特别是对于肝纤维化，如事实所示，28.6％的患者实现纤维化改善。更重要的是，发现肝脏炎症和纤维化改善患者的比例均未显着低于ETV组（53.3％vs 63.3和36.7％vs 43.4％）。大多数基线ALT升高的患者（82.4％）在双环醇治疗后变得正常。更重要的是，如多变量分析所示，双环醇的治疗过程是肝脏炎症改善的独立因素。随着HBeAg状态调整，ALT和HBV-DNA数量，与治疗<48周的患者相比，≥48周治疗患者的优势比（95％置信区间）为5.756（1.893,17.500）。
结论：

双环醇可以改善CHB患者的肝脏炎症和ALT正常化率，特别是当治疗过程延长时。这证实双环醇可以控制肝炎活动，这可能是拒绝抗病毒治疗的CHB患者的良好选择。
关键词：

双环醇;慢性乙型肝炎;肝脏保护药物;肝活检

结论：
31196030
DOI：
10.1186 / s12876-019-1005-1

StephenW

https://bmcgastroenterol.biomedc ... 6/s12876-019-1005-1