慢性B+C型肝炎患者的抗纤维化治疗效果

K. Usychenko
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These limitations emphasize the ongoing need for new therapeutic strategies that target the processes of fibrogenesis. \nThe aim of the work is to assess the possibility of the effect of the drug \"Bicyclol\" on fibrotic changes in patients with chronic hepatitis B+C using a non-invasive scale of the rate of fibrosis. \nMaterials and methods \nAn analysis of the dynamics of 62 patients with chronic hepatitis B and C (HCV+C) was conducted. All patients received long-term antiviral therapy consisting of pegylated interferon for 48 weeks. In the main group (Group I), patients with chronic hepatitis B and C were prescribed the drug \"Bicyclol\" after completing antiviral treatment with interferon. The control group (Group II) followed the principles of proper nutrition and took traditional hepatoprotectors. 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引用次数: 0

摘要

针对慢性病毒性肝炎患者的现代抗病毒治疗方案旨在实现病原体复制的长期抑制(例如慢性乙型肝炎中的核苷类似物)或病毒的完全消除(例如慢性丙型肝炎中的直接作用抗病毒药物)。然而,抗病毒药物对完全恢复生化过程或防止肝脏形态学变化的进一步发展没有显著影响。这些局限性强调了对针对纤维形成过程的新治疗策略的持续需求。这项工作的目的是使用非侵入性纤维化率量表来评估药物“双环醇”对慢性乙型+丙型肝炎患者纤维化变化的影响的可能性。材料与方法对62例慢性乙型和丙型肝炎(HCV+C)患者进行动态分析。所有患者均接受由聚乙二醇干扰素组成的长期抗病毒治疗48周。在主要组(I组)中,慢性乙型和丙型肝炎患者在完成干扰素抗病毒治疗后服用药物“双环醇”。对照组(Ⅱ组)遵循适当营养原则,服用传统护肝药。基于已确定的相关性,提出了一种非侵入性量表来评估肝纤维化进展的个体风险。研究结果在使用抗病毒治疗方案的背景下,在大多数CHB+C患者中观察到细胞溶解指标的正常化,但在一些患者中,这是短暂的。药物“双环醇”的治疗有助于细胞溶解指标的进一步降低,在绝大多数CHB+C患者中,ALT和AST的活性达到了正常值的上限。在仅接受不含抗纤维化成分的基础治疗的CHB+C患者中,观察到转氨酶水平升高的趋势。结论。因此,使用护肝剂“双环醇”12个月可确保肝脏细胞溶解减少,同时降低纤维化的严重程度,在某些患者中,纤维化的发展也会逆转。使用所提出的预后量表可以评估早期预约抗纤维化治疗的必要性。
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RESULTS OF ANTIFIBROTIC THERAPY IN PATIENTS WITH CHRONIC HEPATITIS B+C
Modern antiviral therapy regimens for patients with chronic viral hepatitis aim to achieve either long-term suppression of pathogen replication (e.g., nucleoside analogs in chronic hepatitis B) or complete elimination of the virus (such as direct-acting antiviral drugs in chronic hepatitis C). However, antiviral agents do not have a significant impact on the complete restoration of biochemical processes or the prevention of further progression of morphological changes in the liver. These limitations emphasize the ongoing need for new therapeutic strategies that target the processes of fibrogenesis. The aim of the work is to assess the possibility of the effect of the drug "Bicyclol" on fibrotic changes in patients with chronic hepatitis B+C using a non-invasive scale of the rate of fibrosis. Materials and methods An analysis of the dynamics of 62 patients with chronic hepatitis B and C (HCV+C) was conducted. All patients received long-term antiviral therapy consisting of pegylated interferon for 48 weeks. In the main group (Group I), patients with chronic hepatitis B and C were prescribed the drug "Bicyclol" after completing antiviral treatment with interferon. The control group (Group II) followed the principles of proper nutrition and took traditional hepatoprotectors. Based on the identified correlations, a non-invasive scale was proposed to assess the individual risk of liver fibrosis progression. Research results Against the background of the use of an antiviral treatment regimen, the normalization of cytolysis indicators was observed in most patients with CHB+C, but in some patients it was short-lived. Treatment with the drug "Bicyclol" contributed to a further decrease in cytolysis indicators, in the vast majority of patients with CHB+C, the activity of ALT and AST reached the upper limit of the norm. In patients with CHB+C who received only basic treatment without an antifibrotic component, a tendency to maintain an elevated level of transaminases was observed. Conclusions. Thus, the use of the hepatoprotector "Bicyclol" for 12 months ensures a decrease in cytolysis in the liver, is accompanied by a decrease in the severity of fibrosis, and in some patients - its reverse development. The use of the proposed prognostic scale makes it possible to assess the need for early appointment of antifibrotic therapy.
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