恩替卡韦在慢性HBV携带者抗结核治疗中对ALT、TBIL的影响  

Effect of Entecavir on ALT and TBIL in Anti-Tuberculosis Treatment of Chronic HBV Carriers

作　　者：周裕松 张岩 ZHOU Yusong;ZHANG Yan(Yizheng People's Hospital of Jiangsu Province,Yangzhou,Jiangsu 211400,China)

机构地区：[1]江苏省仪征市人民医院,江苏扬州211400

出　　处：《大医生》2019年第23期162-164,共3页Doctor

摘　　要：目的 探讨恩替卡韦在慢性乙肝病毒(HBV)携带者抗结核治疗中对丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)及肝损伤的影响.方法 对江苏省仪征市人民医院2013年1月至2018年12月收治的肺结核并慢性HBV携带患者62例进行回顾性分析,根据治疗方案分为观察组与对照组,各31例.对照组行常规抗结核治疗,观察组行常规抗结核联合恩替卡韦治疗,2组均连续治疗6个月.比较2组肝损伤发生率、肝损伤出现时间及治疗效果,检测并比较2组治疗前后肝功能指标.结果 观察组患者肝损伤发生率低于对照组,肝损伤出现时间较对照组延长(P<0.05);治疗后2组患者ALT、血清天冬氨酸氨基转移酶(AST)、TBIL均低于治疗前,且观察组低于对照组(P<0.05);观察组治疗总有效率高于对照组(96.77% vs. 58.06%,P<0.05).结论 肺结核并慢性HBV携带者抗结核治疗中应用恩替卡韦,能够降低肝损伤发生率,同时改善ALT、TBIL等肝功能指标,提高临床治疗效果.Objective To investigate the effect of entecavir on ALT,TBIL and liver injury in anti-tuberculosis treatment of chronic HBV carriers.Methods A retrospective analysis was performed on 62 patients with pulmonary tuberculosis and chronic HBV infection admitted to the People's Hospital of Yizheng city,jiangsu province from January 2013 to December 2018.The control group received conventional anti-tb treatment,and the observation group received conventional anti-tb combined entecavir treatment,both groups received continuous treatment for 6 months.The incidence of liver injury,the time of liver injury and the therapeutic effect were compared between the two groups.Results The incidence of liver injury in the observation group was lower than that in the control group,and the time of liver injury was longer than that in the control group(P<0.05).After treatment,ALT,AST,and TBIL were lower in the two groups than before treatment,and the observation group was lower than the control group(P<0.05).;the total effective rate of treatment in the observation group was higher than that in the control group(96.77%vs.58.06%,P<0.05).Conclusion Entecavir can be used in antituberculosis treatment of tuberculosis patients with chronic HBV carriers,which can reduce the incidence of liver injury,improve liver function indexes such as ALT and TBIL,and improve clinical treatment effect.

关 键 词：恩替卡韦 肺结核 慢性HBV携带 抗结核治疗 肝损伤 肝功能 临床效果 

分 类 号：R51[医药卫生—内科学]