恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化96周的临床疗效

发布时间：2018-01-07 07:18

本文关键词：恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化96周的临床疗效　出处：《南方医科大学学报》2016年06期 　论文类型：期刊论文

【摘要】：目的观察恩替卡韦联合复方鳖甲软肝片对慢性乙型肝炎(CHB)肝纤维化患者的临床疗效,探索具有协同治疗作用、促进CHB肝纤维化逆转的联合治疗方案。方法 2010年6月~2015年6月在南方医科大学南方医院感染内科接受抗病毒治疗的CHB肝纤维化患者197例构成随访队列,按年龄、性别、LSM配对后分为恩替卡韦联合复方鳖甲软肝片组(以下简称A组,n=98例)和单用恩替卡韦治疗组(以下简称B组,n=99例),每12周随访1次。检测两组患者HBV DNA定量、血清学指标、血生化指标,肝脏硬度值(LSM)采用Fibro Scan检测,并转换为Metavir分期。结果治疗后两组患者LSM均明显降低(P0.05),A组与B组Metavir分级下降中位时间分别为72周、96周,差异有统计学显著性意义;A组和B组ALT复常中位时间分别为12周、24周,AST复常中位时间分别为24周、36周,差异均有统计学显著性意义。两组HBV DNA阴转率、HBe Ag血清学转换率无明显差异。结论恩替卡韦联合复方鳖甲软肝片能进一步改善CHB肝纤维化患者的总体疗效;对CHB肝纤维化具有协同治疗效应;复方鳖甲软肝片尚具有独立的护肝降酶作用。
[Abstract]:Objective to observe the clinical effect of entecavir combined with compound Biejia Ruangan tablets on chronic hepatitis B patients with CHB liver fibrosis and explore the synergistic effect. Combined therapy to promote the reversal of hepatic fibrosis in CHB. From June 2010 to June 2015, 197 patients with CHB liver fibrosis received antiviral therapy in Southern Hospital infection Department of Southern Medical University. According to age and sex, LSM was divided into two groups: group A (98 cases) and group B (99 cases). All patients were followed up once every 12 weeks. Fibro Scan was used to detect HBV DNA, serological index, blood biochemical index and liver hardness of the two groups. Results after treatment, LSM was significantly decreased in both groups. The median time of Metavir grade decrease in group A and group B was 72 weeks and 96 weeks, respectively. The difference was statistically significant. The median time of ALT restoration in group A and B was 12 weeks, 24 weeks and 36 weeks, respectively. There was significant difference between the two groups. The negative rate of HBV DNA in the two groups was significantly higher than that in the control group. There was no significant difference in serological conversion rate of HBe Ag. Conclusion Entecavir combined with compound Biejia Ruangan tablet can further improve the overall curative effect of CHB patients with hepatic fibrosis. It has synergistic therapeutic effect on CHB hepatic fibrosis. Compound Biejia Ruanggan tablet has an independent function of protecting liver and lowering enzyme.
【作者单位】：广东省病毒性肝炎研究重点实验室//南方医科大学南方医院感染内科;南方医科大学中西医结合医院;
【基金】：国家自然科学基金(81470856) 中国肝炎防治基金会课题(XJS20120601)~~
【分类号】：R512.62;R575.2
【正文快照】： 慢性乙型肝炎(CHB)病程中均伴有程度不等的肝纤维化,这是与HBV所致的肝脏炎症损伤有关联但又不同的病理过程。若不加医学干预,患者可逐渐进展为肝硬化或肝癌。强效HBV复制抑制剂恩替卡韦作为一线抗病毒药物,已经广泛应用于临床并取得了显著疗效。随着HBV被强效抑制,炎症活动常

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