恩替卡韦治疗合并乙型肝炎病毒感染的晚期血吸虫病疗效观察  

The efficacy of entecavir in the patients with advanced schistosomiasis and hepatitis B virus co-infection

作　　者：邱源旺[1] 黄利华[1] 华海涌[2] 牛雪花 吴鹏飞 吴杭源[1] 朱宏英[1] 杨小娟[1] 姚上志[1] 李燚光[1] 

机构地区：[1]无锡市传染病医院肝病科,214000 [2]江苏省寄生虫病防治研究所 [3]昆山第三人民医院消化内科

出　　处：《中华传染病杂志》2012年第4期231-234,共4页Chinese Journal of Infectious Diseases

基　　金：江苏省卫生厅血地寄防应用性科研课题资助项目（X200913）

摘　　要：目的观察恩替卡韦（ETV）治疗合并HBV感染的晚期血吸虫病的疗效及安全性。方法将确诊的60例合并HBV感染的晚期血吸虫病患者分为ETV治疗组30例，大黄治疗组30例（拒绝接受抗病毒治疗），两组在常规治疗基础上分别加用ETV、大黄蛰虫丸治疗，疗程均为52周。比较两组HA、PCⅢ、ⅣC、LN、纤维连接蛋白（FN）等肝纤维化指标及ALT、HBVDNA、Child—Pugh评分结果。分析采用意向性治疗原则（ITT）方法，计量数据和计数数据分别采用t检验和X2检验。结果治疗52周时，ETV治疗组患者HA、PCⅢ、IVC、LN、FN均明显改善，与大黄治疗组比较，差异均有统计学意义（t=3．952、3．765、3．857、3．122、3．735，均Pd0．05）；ETV治疗组部分患者肝组织肝纤维化程度改善，与大黄治疗组比较，差异有统计学意义（X2=11．207，P〈0．05）；ETV治疗组患者ALT、HBVDNA、Child-Pugh评分结果较大黄治疗组明显下降，两组比较，差异均有统计学意义（t=3．287、4．382、3．872，均P〈0．05）；ETV治疗组ALT复常率、HBVDNA在检测水平以下的比率较大黄治疗组明显升高，两组比较，差异有统计学意义（X2=17．376、39．095，均P〈0．05）；且ETV治疗组未出现严重不良反应。结论ETV治疗合并HBV感染的晚期血吸虫病患者安全有效。Objective To evaluate the efficacy and safety profiles of entecavir （ETV） in patients with advanced schistosomiasis and hepatitis B virus （HBV） co-infection. Methods Totally sixty patients with advanced schistosomiasis and HBV co-infection were enrolled in this study. The patients were divided into ETV treatment group （n=30） and rhubarb treatment group who refused to receive antiviral treatment （n= 30）. The patients were treated with ETV or rhubarb thelepus ball on the basis of routine supportive therapy for 52 weeks. The hepatic fibrosis markers （e. g. hyaluronic acid, type Ⅲ procollagen, type Ⅳ collagen, laminin and fibronectin）, alanine transaminase （ALT）, HBV DNA, Child-Pugh score between two groups were compared. Intention to treat （ITT） population was used for analysis. The measurement data and the enumeration data were analyzed by t test and X2 test, respectively. Results After 52-week treatment, the hepatic fibrosis markers （hyaluronic acid, type Ⅲ procollagen, type Ⅳ collagen, laminin and fibronectin） were significantly improved in ETV treatment group compared to the rhubarb treatment group （t = 3. 952, 3.765, 3.857, 3. 122 and 3. 735,respectively; all P〈0.05）, and the fibrosis of liver tissue in ETV treatment group was significantly improved compared with rhubarb treatment group （X2 = 11. 207, P〈0.05 ）. The ALT level, HBV DNA, Child-Pugh score after 52-weeks treatment in ETV treatment group were statistically reduced compared with rhubarb treatment group （t=3. 287, 4. 382 and 3. 872, respectively; all P〈0.05）, meanwhile, the ALT normalization rate and HBV DNA undetectable rate were significantly increased in ETV treatment group （X2 = 17. 376 and 39. 095, respectively; both P〈0.05）. In addition, no obvious adverse reaction was observed during ETV treatment. Conclusion Entecavir is safe and effective in patients with advanced schistosomiasis and HBV co-infection.

关 键 词：晚期血吸虫病 肝炎 乙型 恩替卡韦 

分 类 号：R51[医药卫生—内科学]