Effects of ornithine aspartate combined with alprostadil in the treatment of severe chronic hepatitis B and its effect on serum tumor necrosis factor-α / 中国基层医药

ABSTRACT

Objective To investigate the effect of ornithine aspartate combined with alprostadil in the treatment of severe chronic hepatitis B (CHB),and its effect on serum tumor necrosis factor-α (TNF-α).Methods 80 patients with severe CHB were selected.The patients were divided into the observation group and the control group by digital random method,40 patients in each group.The control group was given conventional treatment of rest,isoglycyrrhizinate magnesium needle,glutathione needle,plasma,albumin,anti-hepatitis B virus.The observation group received ornithine aspartate combined with alprostadil treatment based on the treatment of the control group.After a continuous treatment of 4 weeks,the curative effect was observed,the changes of liver function before and after treatment was compared.Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma TNF-α level,and the adverse reactions during treatment were recorded.Results The total effective rate of the observation group was 92.50％,which was significantly higher than 80.00％ of the control group (x2 =26.588,P ＜ 0.05).The preoperative and postoperative alanine aminotransferase(ALT),prothrombin activity(PTA),total bilirubin (TBIL) of the two groups had statistically significant differences (all P ＜ 0.05),and,there were statistically significant differences between the observation group and the control group after treatment[(86.56 ± 38.67)U/L vs.(121.23 ± 39.65)U/L,(62.45 ±5.46)％ vs.(54.88 ±5.37) ％ and (175.67 ±42.34) μmol/L vs.(214.56 ±43.45) μmol/L,t =3.959,6.252,4.054,all P ＜ 0.001].The plasma TNF-αt level had no statistically significant difference between the two groups before treatment (P ＞ 0.05).After treatment,the TNF-α level of the two groups was significantly decreased,which of the observation group was significantly lower than that of the control group[(176.45 ± 20.41)ng/L vs.(221.43 ± 21.43)ng/L,t =9.613,P ＜ 0.001].The incidence rate of adverse reactions of the observation group was 12.50％,which had no significant difference compared with 10.00％ of the control group (x2 =0.313,P ＞ 0.05).Conclusion Ornithine aspartate combined with alprostadil in the treatment of severe CHB on the basis of the conventional treatment can apparently enhance clinical effect,improve liver function,decrease plasma TNF-α level and adverse reactions.