摘要
目的探讨替诺福韦酯治疗多重耐药乙型病毒性肝炎肝硬化患者的疗效。方法选取沈阳医学院附属中心医院感染科2015年1月至2018年1月收治的70例多重耐药的乙型病毒性肝炎肝硬化患者作为研究对象,按照治疗方法不同分为观察组和对照组,每组35例。观察者患者全程使用替诺福韦酯,给予对照组替诺福韦酯,3个月后转用恩替卡韦,两组均治疗12个月。比较两组患者治疗各阶段的肝功能指标、肾功能指标、乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率。结果治疗前,两组患者各项肝功能指标比较差异无统计学意义(P>0.05),治疗3个月时,各项肝功能指标改善,组间比较差异无统计学意义(P>0.05),治疗6个月时,ALB继续升高,ALT和TBi L继续下降,组间比较差异有统计学意义(P<0.05),治疗12个月时,两组患者的3项肝功能指标比较差异有统计学意义(P<0.05)。两组患者治疗前后各项肾功能指标比较差异无统计学意义(P>0.05)。观察组患者在治疗3、6、12个月时的HBV-DNA转阴率分别为51.4%(18/35)、82.9%(29/35)、94.3%(33/35),对照组患者在治疗3、6、12个月时的HBV-DNA转阴率分别为51.4%(18/35)、65.7%(23/35)、77.1%(27/35),两组患者在治疗6、12个月时的HBV-DNA转阴率比较差异有统计学意义(P<0.05)。结论对多重耐药的乙型病毒性肝炎肝硬化患者使用替诺福韦酯治疗,能有效改善患者的肝功能,提高HBV-DNA转阴率,且对患者肾功能无明显影响,安全性较好。
Objective To investigate the efficacy of tenofovir dipivoxil in the treatment of multidrug resistant patients with hepatitis b cirrhosis. Methods A total of 70 patients with multi-drug resistant hepatitis b cirrhosis admitted to the Department of Infection of Affiliated Central Hospital of Shenyang Medical University from January 2015 to January 2018 were selected as research subjects and were divided into an observation group and a control group according to different treatment method, with 35 cases in each group. Patients in the observation group was treated with tenofovir through the whole process and those in the control group was given tenofovir and entecavir 3 months later. Both groups were treated for 12 months. The indexes of liver function and renal function and HBV DNA negative conversion rate of the 2 groups were compared in different time periods. Results Before treatment, there was no significant difference in liver function between the 2 groups(P>0.05). At 3 months of treatment, liver function indicators improved,and there was no significant difference between the groups(P>0.05). At 6 months of treatment,the ALB kept going up, ALT and TBIL continued to fall,and there were significant differences between the groups. At 12 months of treatment, the differences of 3 liver function indexes between the 2 groups were statistically significant(P < 0.05). The renal function levels of the 2 groups before and after treatment were not statistically significant(P>0.05). In the observation group, the HBV DNA negative conversion rate was 51.4%(18/35), 82.9%(29/35), 94.3%(33/35)at 3, 6 and 12 months after treatment. In the control group, the HBV DNA negative conversion rate was 51.4%(18/35), 65.7%(23/35), 77.1%(27/35)at 3, 6 and 12 months after treatment. The difference of HBV DNA negative conversion rate between the 2 groups at 6 and 12 months after treatment was statistically significant(P<0.05). Conclusion Tenofovir dipivoxil is used in patients with multidrug-resistant hepatitis b cirrhosis.It can effectively i
作者
狄佳
Di Jia(Department of Infectious Diseases,Affiliated Central Hospital of Shenyang Medical College,Shenyang 110024,China)
出处
《中国药物经济学》
2020年第6期76-78,82,共4页
China Journal of Pharmaceutical Economics
