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作 者:苟卫[1,2] 王燕玲[2] 徐筱玮[3] 徐文伟[2]
机构地区:[1]青岛大学医学院,山东青岛266021 [2]青岛市传染病医院门诊部,山东青岛266033 [3]青岛海慈医疗集团内分泌科,山东青岛266033
出 处:《临床肝胆病杂志》2013年第6期456-458,共3页Journal of Clinical Hepatology
摘 要:目的观察恩替卡韦治疗肝源性糖尿病(HD)的临床疗效。方法回顾性分析72例患者的临床资料,按是否应用恩替卡韦抗病毒治疗分为治疗组和对照组各36例。所有患者均给予糖尿病饮食及综合护肝、对症、支持治疗。治疗组给予恩替卡韦0.5 mg,口服,1次/d,观察52周的治疗效果。检测治疗前后患者血清HBV DNA水平,肝功能(ALT、AST、TBil、Alb),血糖,糖化血红蛋白等指标。两组间计量资料比较应用t检验,计数资料比较采用χ2检验。结果治疗52周后,治疗组有29例患者(80.56%)出现病毒学应答,26例(72.22%)肝功能恢复和糖尿病控制;对照组有7例患者(19.44%)出现病毒学应答,16例患者(44.44%)肝功能恢复和糖尿病控制。两组病毒学应答率及糖尿病控制率差异有统计学意义(χ2=18.00,P<0.01;χ2=5.774,P<0.05);治疗组肝功能、血糖等指标较治疗前明显好转,差异有统计学意义(P<0.05),治疗组患者的糖化血红蛋白、空腹血糖均低于对照组,差异有统计学意义(P<0.01)。结论恩替卡韦治疗HBV DNA阳性的乙型肝炎肝硬化伴HD,不但能有效抑制病毒DNA复制,促进肝功能恢复,也能有效控制HD。Objective To observe the clinical efficacy of entecavir in the treatment of hepatogenous diabetes (HD). Methods A retrospective analysis was performed on the clinical data of 72 HD patients, who were divided into treatment group (n = 36) and control group (n = 36). Both groups were given diabetic diet and received liver- protecting treatment, symptomatic treatment, and supportive treatment. In addition, the treatment group received oral entecavir (0.5 mg) once daily. The therapeutic effect was assessed after 52 weeks of treatment; the serum hepatitis B virus (I-IBV) DNA level, liver function ( alaniue aminotransferase, aspartate aminotransferase, total bilirubin, and albumin ), blood glucose, and glycosylated hemoglobin were measured before and after treatment. The two groups were compared by t test ( for measurement data) and chi - square test (for numeration data). Results After 52 weeks of treatment, 29 ( 80.56% ) of the patients in treatment group had virological response, versus 7 ( 19.44% ) of those in control group (X2 = 18.00, P 〈0. 01 ) ; 26 (72.22%) of the patients in treatment group had liver function recovery and controlled diabetes, versus 16 (44.44%) of those in control group (X2 = 5. 774, P 〈 0. 05 ). The treatment group showed significant improvements in liver function and blood glucose after treatment ( P 〈 0.05 ) ; the treatment group had significantly lower glycosylated hemoglobin and fasting blood glucose than the control group ( P 〈 0.01 ). Conclusion In the treatment of HBV DNA - positive hepatitis B cirrhosis with HD, entecavir not only can effectively inhibit the replication of viral DNA and promote the recovery of liver function, but also can effectively control HD.
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