乙型肝炎肝硬化合并骨质疏松患者临床干预的安全性研究  

Safety of clinical intervention on patients with hepatitis B cirrhosis-related osteoporosis

作　　者：李成行 李月翠 Li Chenghang;Li Yuecui(Department of Infectious Diseases,Yongkang First People's Hospital,Jinhua 321300,Zhejiang,China)

机构地区：[1]永康市第一人民医院感染性疾病科,浙江金华321300

出　　处：《国际流行病学传染病学杂志》2019年第6期509-512,共4页International Journal of Epidemiology and Infectious Disease

基　　金：浙江省医药卫生科技计划(2018KY870);永康市科技计划(201719)。

摘　　要：目的探讨给予抗骨质疏松药物干预对慢性乙型肝炎肝硬化合并骨质疏松患者的效果及用药安全性。方法收集2017年6月至2018年6月永康市第一人民医院120例住院确诊为乙型肝炎肝硬化合并骨质疏松患者,随机分为A、B两组各60例。A组给予抗病毒治疗,B组同时行钙剂抗骨质疏松和抗病毒药物治疗,分别测定患者入院第1天、治疗第6个月和第12个月腰椎(L2-4)、股骨颈、大转子等骨密度值、肝硬化程度、ALT及HBV DNA水平,并观察不良反应发生情况。结果第6个月B组患者的L2-4、股骨颈和大转子密度分别为(0.74±0.08)、(0.67±0.04)和(0.51±0.07)g/m^2,第12个月分别为(0.77±0.10)、(0.69±0.07)和(0.54±0.08)g/m^2,均较A组患者明显改善,差异有统计学意义(6个月:t=6.732、4.584和3.983;12个月:t=5.001、5.871和5.001,P均<0.05)。治疗后A、B两组患者的肝硬化程度、ALT、HBV DNA水平较治疗前均有改善,两组间比较差异无统计学意义(P>0.05)。治疗后A、B组不良反应发生率分别为21.67%和23.33%,两组间比较差异无统计学意义(P>0.05)。结论对于合并骨质疏松的肝炎后肝硬化患者同时给予抗骨质疏松治疗可以有效改善肝性骨病进展,未明显影响患者肝功能、肝硬化程度及不良反应情况的发生。Objective To investigate the efficacy and safety of calcium on patients with hepatitis B cirrhosis and osteoporosis.Methods A total of 120 patients with hepatitis B cirrhosis-related osteoporosis in Yongkang First People's Hospital form June 2017 to June 2018 were enrolled in the study.They were randomly divided into two groups:group A(n=60)were treated with antiviral drugs,and group B(n=60)with antiviral drugs and calcium.The levels of bone mineral density at lumbar spine(L2-4),proximal femur and greater trochanter,liver stiffness,ALT and HBV DNA were measured at the first day,the 6th month and the 12th month of treatment.The adverse reactions were observed before and after treatment.Results In group B,the levels of bone mineral density at L2-4,proximal femur and greater trochanter were(0.74±0.08),(0.67±0.04)and(0.51±0.07)g/m^2 at the 6th month,and were(0.77±0.10),(0.69±0.07)and(0.54±0.08)g/m^2 at the 12th month,which were higher than those in group A with significant differences(the 6th month:t=6.732,4.584 and 3.983;the 12th month:t=5.001,5.871 and 5.001,P all<0.05).After the treatment,the liver cirrhosis degree,ALT and HBV DNA were improved in both groups,and there was no significant difference between them(P>0.05).The incidence rates of adverse reactions in group A and B were 21.67%and 23.33%with no significant difference(P>0.05).Conclusions Anti-osteoporosis therapy can improve the osteoporosis in patients with post-hepatitis cirrhosis,and has no bad effect on liver function,the degree of liver cirrhosis as well as the incidence of adverse reactions.

关 键 词：肝炎 乙型 肝硬化 肝性骨病 骨密度 抗骨质疏松药 

分 类 号：R51[医药卫生—内科学]