Effects of compound glycyrrhizin combined with telbivudine on liver fibrosis and inflammatory markers in patients with hepatitis b cirrhosis resistant to adefovir dipivoxil
Objective:To investigate the efficacy and safety of compound glycyrrhizin combined with telbivudi-ne in the treatment of hepatitis B cirrhosis resistant to adefovir dipivoxil.Methods:A retrospective study was con-ducted on the clinical data of 87 patients with hepatitis B cirrhosis resistant to adefovir dipivoxil treated at Xinxiang Infectious Disease Hospital from August 2021 to July 2023.Patients were divided into two groups based on the treatment approach:the control group consisting of 42 patients treated with telbivudine alone and the combined group consisting of 45 patients treated with telbivudine combined with compound glycyrrhizin.After 6 months of treatment,hepatitis B virus deoxyribonucleic acid(HBV-DNA),liver function indicators[alanine aminotrans-ferase(ALT),gamma-glutamyltranspeptidase(γ-GT),total bilirubin(TBIL),albumin(ALB)],liver fibro-sis markers[laminin(LN),hyaluronic acid(HA),type Ⅲ procollagen peptide(P Ⅲ P),type IV collagen(Ⅳ-C)],inflammatory markers[interleukin-6(IL-6),IL-12,IL-18,tumor necrosis factor-α(TNF-α)],and adverse reactions were compared between the two groups.Results:There was no statistically significant differ-ence in HBV-DNA levels between the two groups after treatment(P＞0.05).After treatment,ALT,γ-GT and TBIL levels in the combined group were(39.35±5.08)U/L,(41.02±6.94)U/L and(19.60±2.64)μmioL/L,respectively,which were lower than those in the control group[(50.62±8.05)U/L,(50.83±5.72)U/L,and(28.73±3.05)μmoL/L,respectively],while ALB levels were higher in the combined group(45.86±3.02)g/Lcompared to the control group(36.92±4.05)g/L.These differences were statistically significant(P＜0.05).After treatment,the levels of LN,HA,P Ⅲ P and Ⅳ-C in the combined treatment group were(90.64±10.23)μg/L,(89.60±5.42)μg/L,(106.37±20.60)μg/L and(85.31±10.09)μg/L,respec-tively,which were lower than those in the control group at(110.06±15.64)µg/L,(108.82±8.07)μg/L,(131.54±23.87)μg/L and(101.02±13.55)µg/L,respectively.The differences were statistically significant(P＜0.05).After treatment,the levels of IL-6,IL-18,IL-22,and TNF-α in the combined treatment group were(56.90±8.63)pg/mL,(130.08±20.62)pg/mL,(68.62±15.84)pg/mL,and(0.34±0.13)μg/L,respectively,which were lower than those in the control group at(79.64±10.57)pg/mL,(152.93±25.86)pg/mL,(92.37±10.09)pg/mL,and(0.61±0.15)µg/L,respectively.The differences were statisti-cally significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(15.56％vs 14.29％,P＞0.05).Conclusion:The combination of compound glycyrrhiz-in and telbivudine in the treatment of hepatitis B cirrhosis resistant to adefovir dipivoxil can improve liver function and liver fibrosis,inhibit inflammatory reactions,and is relatively safe.
compound glycyrrhizintelbivudineadefovir dipivoxilhepatitis B Cirrhosisliver fibrosisin-terleukin
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