恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病的效果观察  

Efficacy of entecavir in the treatment of chronic hepatitis B complicated with nonalcoholic fatty liver disease

作　　者：高红伟[1] 毛重山 张淑凤[1] 朱海洋[1] 韩仙芝[1] Gao Hongwei;Mao Chongshan;Zhang Shufeng;Zhu Haiyang;Han Xianzhi(Department of Gastroenterology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Infectious Diseases,Zhengzhou University People’s Hospital,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第五附属医院消化内三科,450000 [2]郑州大学人民医院河南省人民医院感染性疾病科,450003

出　　处：《中国实用医刊》2020年第22期85-88,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划项目(162102310284)。

摘　　要：目的:观察恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病的效果。方法:抽取2018年1月至2020年1月于郑州大学第五附属医院接受治疗的80例慢性乙型肝炎合并非酒精性脂肪性肝病患者,采用随机数字表法将其分为对照组与研究组,对照组40例采用双环醇治疗,研究组40例采用恩替卡韦治疗,比较治疗前后两组患者肝功能指标、血清肝纤维化指标、肝组织脂肪变化情况及临床疗效。结果:治疗前两组患者肝功能指标情况、血清肝纤维化指标比较差异未见统计学意义(P<0.05),治疗12周研究组患者肝功能指标如天门冬氨酸氨基转移酶、丙氨酸氨基转移水平均低于对照组(P<0.05),血清肝纤维化指标如血清Ⅲ型前胶原、Ⅳ型胶原蛋白、层黏连蛋白及透明质酸酶水平均低于对照组(P<0.05);研究组患者肝组织脂肪变化情况评价优于对照组(P<0.05),临床疗效评价优于对照组(P<0.05)。结论:慢性乙型肝炎合并非酒精性脂肪性肝病患者临床治疗使用恩替卡韦治疗,可有效改善其肝功能指标、血清肝纤维化指标,促进肝功能恢复的同时减轻肝组织脂肪变化,提高治疗效果。Objective To observe the efficacy of entecavir in the treatment of chronic hepatitis B patients with non-alcoholic fatty liver disease.Methods Eighty patients with chronic hepatitis B and non-alcoholic fatty liver disease who were treated in the Fifth Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were divided into control group and research group according to random number table method.Forty cases in the control group were treated with bicyclol,while 40 cases in the study group were treated with entecavir.The liver function indexes,serum liver fibrosis indexes,liver tissue fat changes and clinical efficacy were compared between the two groups before and after treatment.Results There was no significant difference in liver function indexes and serum liver fibrosis indexes between the two groups before treatment(P<0.05).After 12 weeks of treatment,the liver function indexes such as aspartate aminotransferase and alanine aminotransferase in the study group were lower than those in the control group(P<0.05),and the serum liver fibrosis indexes were lower than those in the control group(P<0.05).The evaluation of liver tissue fat changes in the group was better than that in the control group(P<0.05),and the clinical efficacy evaluation was better than that in the control group(P<0.05).Conclusions Entecavir can effectively improve the liver function index and serum liver fibrosis index in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease,promote the recovery of liver function,reduce the changes of liver tissue fat,and improve the treatment effect.

关 键 词：慢性乙型肝炎 非酒精性脂肪性肝病 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学] R575.5[医药卫生—临床医学]