恩替卡韦治疗脾部分栓塞术后乙型肝炎肝硬化并脾功能亢进的效果观察  

Efficacy of entecavir in treatment of hepatitis B cirrhosis and hypersplenism after partial splenic embolization

作　　者：江凌翔[1] 陈宜德 林慧[1] Jiang Lingxiang;Chen Yide;Lin Hui(Department of 18th District,the First People＆ Hospital of Taizhou,Taizhou,Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院十八病区,浙江省台州318020

出　　处：《中国基层医药》2018年第16期2091-2094,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨恩替卡韦治疗脾部分栓塞术后乙型肝炎肝硬化并脾功能亢进的效果.方法 回顾性分析2016年2～10月在台州市第一人民医院住院的乙型肝炎肝硬化合并脾功能亢进患者92例的临床资料,其中采用部分栓塞术后采用拉米夫定抗病毒治疗的作为对照组46例,在部分栓塞术后给予恩替卡韦片治疗的作为观察组,共46例.在连续治疗36周之后,比较两组的肝纤维化情况：Ⅲ型前胶原（PC-Ⅲ）、血清透明质酸（HA）、Ⅳ型胶原（Ⅳ-C）.比较两组肝功能情况：总胆红素（TBil）、丙氨酸氨基转移酶（ALT）、血清白蛋白（ALB）、天门冬氨酸氨基转移酶（AST）.比较两组的乙型肝炎病毒（HBV）控制情况：HBeAg/抗-HBe转阴、HBV DNA转阴情况.结果 肝纤维化：观察组PC-Ⅲ、HA、Ⅳ-C分别为（93.6±31.3）U/L、（83.2±25.4） U/L、（85.5±25.4）μmol/L,明显低于对照组的（148.6±24.4） U/L、（152.2±34.5）U/L、（146.1±36.6） μmol/L,差异均有统计学意义（t=3.457、3.848、4.065,均P＜0.05）.肝功能：观察组TBil、AST、ALT分别为（21.4±5.4） μmol/L、（60.1±20.6） U/L、（52.4±15.4）U/L,明显低于对照组的（51.1±6.7） μmol/L、（116.4±25.5） U/L、（110.9±20.5）U/L,观察组ALB（35.9±2.8） g/L,明显高于对照组的（31.2±1.5）g/L,差异均有统计学意义（t=4.106、3.763、2.945、2.966,均P＜0.05）.HBV控制（HBeAg/抗-HBe转阴）：观察组与对照组分别为13例和2例,差异有统计学意义（x2 =5.035,P＜0.05）;HBV DNA转阴观察组与对照组分别为15例、2例,差异有统计学意义（x2 =5.364,P＜0.05）.结论 乙型肝炎肝硬化合并脾功能亢进行部分栓塞后采用恩替卡韦可控制HBV复制,改善肝功能,并对肝纤维化有逆转作用.Objective To investigate the efficacy of entecavir after partial embolization in patients with hepatitis B cirrhosis complicated with hypersplenism.Methods From February 2016 to October 2016,the clinical data of 92 patients with hepatitis B cirrhosis and hypersplenism in the First People ＇s Hospital of Taizhou were retrospectively analyzed.Among them,46 cases were treated with lamivudine antiviral therapy after partial embolization as the control group.46 cases were treated with entecavir tablets after partial embolization as the observation group.After 36 weeks of contact therapy,liver fibrosis was compared between the two groups：procollagen Ⅲ （PC-Ⅲ）,serum hyaluronic acid （HA）,collagen Ⅳ （Ⅳ-C）.The liver function of the two groups were compared：total bilirubin （TBil）,alanine transaminase （ALT）,albumin （ALB）,aspartate aminotransferase （AST）.The the control of hepatitis B virus were compared between the two groups：HBeAg/anti-HBe negative,negative HBV DNA.Results Liver fibrosis：the levels of PC-Ⅲ,HA and Ⅳ-C in the observation group were （93.6 ± 31.3） U/L,（83.2 ± 25.4） U/L and （85.5 ± 25.4） μ mol/L,respectively,which were significantly lower than those in the control group [（148.6 ± 24.4） U/L,（152.2 ± 34.5） U/L and （146.1 ± 36.6） μmol/L],the differences were statistically significant （t =3.457,3.848,4.065,all P 〈 0.05）.Liver function：the levels of TBil,AST and ALT in the observation group were （21.4 ± 5.4） μmol/L,（60.1 ± 20.6） U/L,（52.4 ± 15.4） U/L,respectively,which were significantly lower than those in the control group [（51.1 ± 6.7） μmol/L、（116.4 ± 25.5） U/L、（110.9 ± 20.5） U/L],the differences were statistically significant（t =4.106,3.763,2.945,all P 〈 0.05）.The ALB in the observation group was significandy higher than that in the control group [（31.2 ± 1.5） g/L vs.（35.9 ± 2.8） g/L,t =2.966,P 〈0.05].Hepatitis B virus control：the observation group and control group had 1

关 键 词：肝硬化 肝炎病毒 乙型 脾功能亢进 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]