摘要
目的观察核苷类抗病毒药物联合微生态制剂治疗HBV感染失代偿期肝硬化患者的临床疗效。方法选取2014年1月—2016年1月新疆医科大学第五附属医院消化内科住院的HBV感染失代偿期肝硬化患者82例作为研究对象。采用随机数字表法分为2组,每组41例。对照组给予常规治疗+恩替卡韦分散片,观察组在对照组基础上口服双歧杆菌三联活菌胶囊, 2组均治疗48周。比较2组患者临床疗效、肝功能指标、肝纤维化指标、肝脾影像学指标以及抗病毒相关指标。结果观察组总有效率为95.12%,高于对照组的80.49%(χ~2=4.100,P=0.043);与治疗前比较,2组患者治疗24周、48周后ALT、AST、TBil、LN、HA、PCⅢ、CⅣ、门静脉内径、脾静脉内径、脾脏厚度水平均明显降低,Alb明显升高(P<0.01),且观察组48周后各项指标改善均优于对照组(t/P=16.287/0.000、15.276/0.000、8.482/0.000、5.163/0.002、9.762/0.000、15.262/0.000、14.732/0.000、10.824/0.000、3.647/0.017、11.636/0.000、9.842/0.000);2组HBV-DNA水平显著下降且观察组降低优于对照组(t=5.264,P=0.000),HBV-DNA转阴率、HBeAg转阴率均显著高于对照组(χ~2/P=4.100/0.043、4.479/0.034)。结论核苷类抗病毒药物联合微生态制剂治疗HBV感染失代偿期肝硬化患者具有良好的临床疗效,能够明显改善肝功能、减轻肝纤维化程度,并能有效抑制HBV复制,具有一定的临床推广应用价值。
Objective To observe the clinical efficacy of nucleoside antiviral drugs combined with microecological agents in the treatment of Decompensated Hepatocirrhosis due to HBV infection.Methods From January 2014 to January 2016,82 patients with decompensated liver cirrhosis due to HBV infection in the Department of Gastroenterology,Fifth Affiliated Hospital of Xinjiang Medical University were selected as the study subjects.Random number table method was used to divide them into two groups,41 cases in each group.The control group was given routine treatment plus entecavir dispersible tablets,while the observation group was given Bifidobacterium triple viable capsules on the basis of the control group.Both groups were treated for 48 weeks.The clinical efficacy,liver function index,liver fibrosis index,liver and spleen imaging index and anti-virus related index were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(95.12%vs.80.49%,χ^2=4.100,P=0.043).Compared with before treatment,after treatment for 24 weeks and 48 weeks,ALT,AST,TBil,LN,The levels of HA,PCIII,CIV,portal vein diameter,spleen vein diameter and spleen thickness were significantly decreased,Alb was significantly increased(P<0.01),and the improvement of all indexes in the observation group was better than that of the control group(t/P=16.287/0.000,t/P=15.276/0.000,t/P=8.482/0.000,t/P=5.163/0.002,t/P=9.762/0.000,t/P=15.262/0.000,t/P=14.732/0.000,t/P=10.824/0.000,t/P=3.647/0.017,t/P=11.636/0.000,t/P=9.842/0.000);the liver function and liver fibrosis index of the observation group were significantly lower than the control group at the same time(P<0.01).The levels of HBV DNA in the two groups decreased significantly and the observation group decreased better than the control group(t=5.264,P=0.000).The HBV DNA negative rate and HBeAg negative rate were significantly higher than the control group(χ^2/P=4.100/0.043,χ2/P=4.479/0.034).Conclusion Nucleoside antiviral drugs combined wit
作者
侯慧
刘慧敏
周丽莉
刘晶
何思锐
李可
HOU Hui;LIU Huimin;ZHOU Lili;LIU Jing;HE Sirui;LI Ke(Department of Gastroenterology,Fifth Affiliated Hospital of Xinjiang Medical University Urumqi,Xinjiang Procince,Urumqi 830011,China)
出处
《疑难病杂志》
CAS
2019年第4期369-373,共5页
Chinese Journal of Difficult and Complicated Cases
