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Effects of six months losartan administration on liver fibrosis in chronic hepatitis C patients: a pilot study.

机译:六个月服用氯沙坦对慢性丙型肝炎患者肝纤维化的影响:一项初步研究。

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AIM: To evaluate the safety and efficacy of chronic administration of losartan on hepatic fibrosis in chronic hepatitis C patients. METHODS: Fourteen patients with chronic hepatitis C non-responders (n = 10), with contraindications (n = 2) or lack of compliance (n = 2) to interferon plus ribavirin therapy and liver fibrosis were enrolled. Liver and renal function test, clinical evaluation, and liver biopsies were performed at baseline and after losartan administration at a dose of 50 mg/d during the 6 mo. The control group composed of nine patients with the same inclusion criteria and paired liver biopsies (interval 6-14 mo). Histological activity index (HAI) with fibrosis stage was assessed under blind conditions by means of Ishak's score. Subendothelial fibrosis was evaluated by digital image analyses. RESULTS: The changes in the fibrosis stage were significantly different between losartan group (decrease of 0.5+/-1.3) and controls (increase of 0.89+/-1.27; P<0.03). In the treated patients, a decrease in fibrosis stage was observed in 7/14 patients vs 1/9 control patients (P<0.04). A decrease in sub-endothelial fibrosis was observed in the losartan group. No differences were found in HAI after losartan administration. Acute and chronic decreases in systolic arterial pressures (P<0.05) were observed after the losartan administration, without changes in mean arterial pressure or renal function. CONCLUSION: Chronic AT-II type 1 receptor (AT1R) blockade may reduce liver fibrosis in patients with chronic hepatitis C.
机译:目的:评价长期服用氯沙坦对慢性丙型肝炎患者肝纤维化的安全性和有效性。方法:招募了十四例慢性丙型肝炎无反应者(n = 10),禁忌症(n = 2)或对干扰素加利巴韦林治疗和肝纤维化的依从性不足(n = 2)。在基线和6个月内以50 mg / d的剂量服用氯沙坦后,于基线和进行肝和肾功能测试,临床评估以及肝活检。对照组由9名具有相同纳入标准的患者组成,并进行了配对的肝活检(间隔6-14 mo)。通过Ishak评分在盲条件下评估纤维化分期的组织学活动指数(HAI)。通过数字图像分析评估内皮下纤维化。结果:氯沙坦组(减少0.5 +/- 1.3)和对照组(增加0.89 +/- 1.27; P <0.03)之间的纤维化阶段变化有显着差异。在接受治疗的患者中,与对照组的1/9患者相比,有7/14的患者出现纤维化分期的减少(P <0.04)。在氯沙坦组中观察到了内皮下纤维化的减少。氯沙坦给药后在HAI中未发现差异。服用氯沙坦后观察到收缩期动脉压的急性和慢性下降(P <0.05),平均动脉压或肾功能没有变化。结论:慢性AT-II 1型受体(AT1R)阻滞剂可减少慢性丙型肝炎患者的肝纤维化。

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