摘要
目的 探讨胸腺肽联合恩替卡韦治疗乙肝肝硬化的疗效及对患者肝功能、炎症指标水平的影响。方法回顾性选取2020年6月—2021年6月于龙岩市第二医院接受治疗的186例乙肝肝硬化患者的临床资料进行分析,按照治疗方法的不同,将接受恩替卡韦治疗的91例患者纳入常规组,接受胸腺肽联合恩替卡韦治疗的95例患者则纳入联合组。两组治疗时间均为6个月,治疗后比较两组肝功能指标,包括天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)以及白蛋白(ALB),对比两组肝纤维化指标,有C型胶原(C-IV)、层黏连蛋白(LN)和血清透明质酸(HA),同时记录治疗前后两组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)与超敏C反应蛋白(hs-CRP)水平,评估两组治疗总有效率并观察其不良反应。结果 治疗后,联合组AST、TBIL水平均比常规组低,而ALB则高于常规组,差异有统计学意义(P<0.05);联合组C-IV、LN、HA、IL-6、IL-8、hs-CRP均比常规组低,差异有统计学意义(P<0.05);联合组治疗总有效率为98.95%,较常规组的91.21%高,差异有统计学意义(χ^(2)=4.481,P<0.05);联合组和常规组不良反应发生率为7.37%、5.49%,差异无统计学意义(P>0.05)。结论 对乙肝肝硬化患者采用胸腺肽联合恩替卡韦的治疗方案能有效改善患者肝功能水平,降低肝纤维化,可对炎症指标进行良好控制,且联合用药并未增加额外用药风险,可作为乙肝肝硬化治疗的优选方案。
Objective To investigate the efficacy of thymidine combined with entecavir in the treatment of hepatitis B cirrhosis and the effect on the level of liver function and inflammatory indexes in patients.Methods 186 patients with hepatitis B cirrhosis treated in Longyan Second Hospital from June 2020 to June 2021 retrospective selection,and 91 patients treated with entecavir were included in the conventional group and 95 patients treated with thymidine combined with entecavir were included in the combined group according to the treatment method.The duration of treatment in two groups was 6 months,and liver function indicators,including aspartate aminotransferase(AST),total bilirubin(TBIL),and albumin(ALB),were compared between the two groups after treatment.Liver fibrosis indexes were compared between the two groups,with collagen type C(C-IV),laminin(LN),and serum hyaluronic acid(HA).The levels of interleukin-6(IL-6),interleukin-8(IL-8)and hypersensitive C-reactive protein(hs-CRP)were also recorded in both groups before and after treatment.The total efficiency of treatment in two groups were assessed and adverse effects were observed.Results After treatment,AST and TBIL levels in the combined group were lower than those in the conventional group,while ALB was higher than that in the conventional group,the differences was statistically significant(P<0.05);C-IV,LN,HA,IL-6,IL-8 and hs-CRP in the combined group were lower than those in the conventional group,the differences was statistically significant(P<0.05).The total effective rate of treatment in the combined group was 98.95%,which was higher than 91.21%in the conventional group,the differences was statistically significant(χ^(2)=4.481,P<0.05);the incidence of adverse reactions in the combined and conventional groups were 7.37%and 5.49%,respectively,and the difference was not statistically significant(P>0.05).Conclusion The treatment regimen of thymidine combined with entecavir in patients with hepatitis B cirrhosis can effectively improve the level of liver function and reduce liver fibrosis,and can provide good control of inflammatory indexes,and the combination did not increase the risk of additional medication,so it can be used as a preferable regimen for the treatment of hepatitis B cirrhosis.
作者
邱小辉
林承春
王林娣
QIU Xiaohui;LIN Chengchun;WANG Lindi(Department of Infectious Diseases,Longyan Second Hospital,Longyan,Fujian Province,364000 China;Department of Gastroenterology,Longyan Second Hospital,Longyan,Fujian Province,364000 China)
出处
《中外医疗》
2022年第35期159-162,167,共5页
China & Foreign Medical Treatment
关键词
胸腺肽
恩替卡韦
肝功能
炎症指标
Thymidine
Entecavir
Liver function
Inflammatory index
