阿德福韦或恩替卡韦联合甘草酸二铵治疗慢性乙型肝炎患者临床研究  

Combination of adefovir or entecavir and diammonium glycyrrhizinate in the treatment of patients with chronic hepatitis B

作　　者：史罗明[1] 周根法[1] 

机构地区：[1]江苏省常州市第三人民医院肝病科,213000

出　　处：《实用肝脏病杂志》2018年第1期54-57,共4页Journal of Practical Hepatology

摘　　要：目的探讨阿德福韦或恩替卡韦联合甘草酸二铵治疗慢性乙型肝炎(CHB)患者的临床疗效。方法2013年2月~2016年1月我院收治的200例CHB患者,分成三组,分别给予甘草酸二铵肠溶胶囊(n=80)、甘草酸二胺肠溶胶囊联合阿德福韦(n=60)或甘草酸二胺肠溶胶囊联合恩替卡韦(n=60)治疗,观察1年。采用ELISA法检测血清HBV标志物,采用荧光定量PCR法检测血清HBV DNA,使用美国贝克曼库尔特公司生产的AU5800型全自动生化分析仪检测血生化指标。常规行肝活检术,应用组织学活动指数(HAI)评分评估肝脏炎症活动度。结果在治疗1年末,阿德福韦组和恩替卡韦组患者血清HBV DNA转阴率、HBe Ag阴转率和ALT复常率分别为91.7%、18.3%和86.7%和88.3%、16.7%和85.0%,显著高于对照组的15.0%、6.3%和51.3%(P<0.05或P<0.01);阿德福韦组和恩替卡韦组肝组织HAI评分、ALT、TBIL和AST水平分别为【(3.5±1.3)分、(54.1±12.2)U/L、(16.4±4.1)μmol/L、(35.3±6.1)U/L】和【(3.2±1.5)分、(53.4±13.0)U/L、(16.0±4.1)μmol/L、(34.1±6.3)U/L】,其中HAI评分和ALT水平显著低于对照组【分别为(6.3±1.5)分、(59.3±15.7)U/L、(18.0±4.5)μmol/L、(38.4±7.1)U/L,P<0.05或P<0.01】;阿德福韦组与恩替卡韦组血清HBV DNA转阴率、HBeAg阴转率、ALT复常率、HAI评分、肝功能各项指标相比较,无统计学差异(P>0.05)。结论阿德福韦或恩替卡韦联合甘草酸二铵治疗CHB患者临床疗效显著,在抑制乙型肝炎病毒复制、抑制肝组织炎症及保护肝功能方面发挥治疗作用。Objective To investigate the clinical efficacy of combination of adefovir or entecavir and diammonium glycyrrhizinate in the treatment of patients with chronic hepatitis B （CHB）. Methods A total of 200 patients with CHB were recruited in our hospital between February 2013 and Janumy 2016,and were randomly divided into control group （n=80） receiving diammonium glycyrrhizinate orally,or combination of adefovir （n=60） or entecavir and diammonium glycyrrhizinate （n=60） therapy for 12 months. The negative conversion rate of hepatitis B virus deoxyribonucleic acid （HBV DNA） and hepatitis B e antigen （HBeAg）,normalization rate of serum alanine aminotransferase（ALT）J,and histological activity index（HAI） were compared among the three groups. Results There was no significant differences as respect to serum ALT,bilirubin and AST levels among the three groups before treatment （P〉0.05）;At the end of 12 month treatment,the negative conversion rates of serum HBV DNA,negative conversion rates of serum HBeAg and normalization rates of ALT in the adefovir-treated group were 91.7%,18.3% and 86.7%,and were 88.3%,16.7%and 85.0% in entecavir-treated group,both significantly higher than 15.0%,6.3% and 51.3% in the diammonium glyeyrrhizinate alone treated group （P〈0.05 or P〈0.01）; the HAl scores,ALT,TBIL and AST levels in the adefovir-treated group were （3.5±1.3）, （54.1±12.2） U/L,（16.4± 4.1） μmol/L and （35.3±6.1） U/L,and were （3.2±1.5）, （53.4±13.0） U/L, （16.0±4.1）μmol/L and （34.1±6.3）U/L in the entecavir-treated group,significantly lower except TBIL and AST than （6.3±1.5）,（59.3±15.7） U/L,（18.0±4.5） tzmol/L and （38.4±7.1） U/L in the diammonium zlvcvrrhizinate alone treated grouo （P〈0.05）;there were nosignificant differences as respect to the above indexes between adefovir-treated and entecavir-treated groups （P〉O.05）. Conclusion Combination of adefovir or entecavir and diammonium glycyrrhizinate in the treatment of pati

关 键 词：慢性乙型肝炎 阿德福韦 恩替卡韦 甘草酸二胺 治疗 

分 类 号：R512.62[医药卫生—内科学]