Clinical Efficacy of Gandouling Combined with Short-term Decoppering on Hepatic Fibrosis of Wilson's Disease Based on Transient Elastography
10.13422/j.cnki.syfjx.20221394
- VernacularTitle:基于TE技术探讨肝豆灵联合短期驱铜治疗对Wilson病肝纤维化的临床疗效
- Author:
Yu ZHANG
1
;
Meixia WANG
2
;
Jing ZHANG
2
;
Qian ZHAO
1
;
Meng ZHANG
1
;
Yiming CHEN
1
;
Zhonglei LI
1
Author Information
1. Department of Graduate School， Anhui University of Chinese Medicine，Hefei 230038，China
2. The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230031，China
- Publication Type:Journal Article
- Keywords:
hepatic fibrosis;
hepatolenticular degeneration;
Gandouling;
transient elastography;
liver stiffness measurement;
serum fibrosis index
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2022;28(13):123-129
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the accuracy of clinical common serum fibrosis indexes hyaluronic acid （HA）， type Ⅳ collagen （CⅣ）， laminin （LN）， and type Ⅲ procollagen peptide （PⅢNP）， in combination with liver stiffness measurement （LSM， measured by transient elastography） and non-invasive markers of fibrosis aspartate aminotransferase to platelet ratio index （APRI） and fibrosis-4 （FIB-4） in the prediction of the hepatic fibrosis of Wilson's disease （WD） and to observe the clinical effect of Gandouling （GDL）. MethodThe data of 76 WD patients were collected and the LSM， serum fibrosis indexes （HA， PⅢNP， CⅣ， LN）， APRI， and FIB-4 before treatment were recorded. The correlation of LSM with serum fibrosis indexes， APRI， and FIB-4 was discussed via Pearson′s correlation analysis. According to the therapeutic schemes， patients were classified into the control group （36 cases） and treatment group （40 cases）. Patients in control group were treated with sodium dimercaptopropylsulfonate （DMPS）， while those in the treatment group received GDL in addition to the western medicine therapy. The treatment lasted 6 courses （8 days/course） and the influence of GDL on the indictors was evaluated. ResultHA， CⅣ， LN， PⅢNP， APRI， and FIB-4 were in positive correlation with LSM （r=0.517， 0.438， 0.281， 0.457， 0.778， 0.847， P<0.01）. HA， CⅣ， LN， and PⅢNP in the treatment group were lower after treatment than before treatment （P<0.05， P<0.01）. HA， CⅣ， and LN in the control group were lower after treatment than before treatment （P<0.05， P<0.01）， and PⅢNP showed no significant difference. LSM， FIB-4， and APRI in both groups decreased after treatment （P<0.05）. After treatment， LSM， FIB-4， APRI， HA， and PⅢNP in the treatment group were lower than those in the control group （P<0.05， P<0.01）， but CⅣ and LN demonstrated no significant difference from the control group. ConclusionLSM in combination with serum fibrosis indexes （HA， PⅢNP， CⅣ， LN）， FIB-4， and APRI can help accurately identify the level of the hepatic fibrosis in WD. Moreover， on the basis of decoppering by western medicine， GDL can significantly improve the liver function and hepatic fibrosis of WD patients.
