摘要
目的观察恩替卡韦联合水飞蓟宾治疗慢性乙型肝炎(CHB)患者疗效及其对肝功能、肝纤维化和炎性反应的影响。方法回顾性分析2016年4月—2018年1月长沙市第一医院感染科治疗的CHB患者127例的临床资料,按照治疗方法的不同分为对照组(57例)和联合组(70例)。对照组口服恩替卡韦片治疗,联合组在对照组基础上联合水飞蓟宾治疗,治疗周期均为48周。比较2组临床疗效、治疗前后肝功能指标、肝纤维化指标和炎性因子水平,观察不良反应情况。结果联合组临床疗效明显高于对照组(92.86%vs. 75.44%,χ~2=7.492,P=0.006)。治疗后,2组患者的TBil、ALT和AST水平均下降,且联合组低于对照组(t=35.391、5.679、6.047,P均=0.000);Alb水平均升高,联合组高于对照组(t=22.424,P=0.000);2组患者的HA、LN和IVC水平均下降,联合组均低于对照组(t=4.817、5.099、7.037,P均=0.000)。2组患者的IL-6、TNF-α和TGF-β水平均下降,INF-γ水平均升高(t=11.372、17.291、13.576,t=3.566,P均=0.001),且联合组低/高于对照组;2组未发现不良反应。结论恩替卡韦联合水飞蓟宾可显著改善CHB患者肝功能和炎性状态,降低肝纤维化水平,且安全性良好,值得临床推广。
Objective To observe the efficacy of entecavir combined with silybin in the treatment of chronic hepatitis B(CHB)and its effects on liver function,liver fibrosis and inflammatory response.Methods The clinical data of 127 CHB patients treated in the Infectious Department of the First Hospital of Changsha City from April 2016 to January 2018 were retrospectively analyzed.They were divided into control group(57 cases)and combined group(70 cases)according to different treatment methods.The control group was treated with entecavir tablets,while the combined group was treated with silybin on the basis of the control group.The treatment period was 48 weeks.The clinical efficacy,liver function,liver fibrosis and inflammatory factors were compared before and after treatment,and adverse reactions were observed.Results The clinical efficacy of the combined group was significantly higher than that of the control group(92.86%vs.75.44%,χ^2=7.492,P=0.006).After treatment,the levels of TBil,ALT and AST decreased in the two groups,and the combined group was lower than the control group(t=35.391,t=5.679,t=6.047,P=0.000);Alb water increased,the combined group Higher than the control group(t=22.424,P=0.000);the HA,LN and IVC levels of the two groups decreased,and the combined group was lower than the control group(t=4.817,t=5.099,t=7.037,P=0.000).The levels of IL 6,TNF-αand TGF-βin the two groups decreased,and the INF-γlevels increased(t=11.372,t=17.291,t=13.576,t=3.566,P=0.001),and the combined group was superior to the control group;No adverse reactions were found in either group.Conclusion Entecavir combined with silybin can significantly improve the liver function and inflammatory state of CHB patients,reduce the level of liver fibrosis,and has good safety,which is worthy of clinical promotion.
作者
李丽萍
闻名
刘长明
卢瑾
占春玲
李向军
LI Liping;WEN Ming;LIU Changming;LU Jin;ZHAN Chunling;LI Xiangjun(Department of Infection, the First Hospital of Changsha City, Hunan Province,Changsha 410000,China)
出处
《疑难病杂志》
CAS
2019年第3期247-250,共4页
Chinese Journal of Difficult and Complicated Cases
