替诺福韦酯补救治疗乙型肝炎病毒感染肝硬化患者的临床效果  

Clinical effect of tenofovir dipivoxil in the remedial treatment of patients with hepatitis B virus infection with liver cirrhosis

作　　者：彭芳 郭婷[1] 廖群 王伟新[1] PENG Fang;GUO Ting;LIAO Qun;WANG Weixin(Department of Infectious Diseases,Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun,Jiangxi,336000,China)

机构地区：[1]江西省宜春学院第二附属医院感染科,江西宜春336000

出　　处：《当代医学》2022年第19期152-155,共4页Contemporary Medicine

基　　金：江西省宜春市科学技术局社会发展类科技计划(JXYC2019KSA021)。

摘　　要：目的 研究替诺福韦酯在乙型肝炎病毒(HBV)感染肝硬化补救治疗中的效果。方法 选取2017年12月至2019年1月本院收治的76例乙型肝炎病毒感染肝硬化患者作为研究对象,通过随机数字表法分为两组,每组38例。对照组采用恩替卡韦进行治疗,观察组采用恩替卡韦和替诺福韦酯联合治疗,比较两组肝功能指标[清蛋白(ALB)、谷草转氨酶(AST)、总胆红素(TBiL)]水平、肝硬度值、肝脾超声指标(门静脉内径、脾静脉内径及脾厚度)、治疗后HBV-DNA转阴率及治疗期间不良反应发生率。结果 治疗后,两组AST、TBiL水平均低于治疗前,ALB高于治疗前,且观察组AST、TBiL水平均低于对照组,ALB高于对照组,差异有统计学意义(P<0.05)。观察组脾厚度薄于对照组,门静脉内径及脾静脉内径短于对照组,差异有统计学意义(P<0.05);治疗12、24、48周后,观察组HBV-DNA转阴率均高于对照组,差异有统计学意义(P<0.05)。观察组治疗期间不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 采用替诺福韦酯补救治疗HBV感染肝硬化患者,能有效控制肝硬化的恶性发展,改善患者肝功能指标,提高HBV-DNA转阴率,安全性较高,值得临床推广应用。Objective To study the effect of tenofovir disoproxil in salvage therapy of hepatitis B virus(HBV) infection with liver cirrhosis.Methods A total of 76 patients with hepatitis B virus(HBV) infection with liver cirrhosis who were admitted to our hospital from December2017 to January 2019 were selected as the research subjects, and they were divided into two groups by random number table method, with 38 cases in each group. The control group was treated with entecavir, and the observation group was treated with entecavir and tenofovir disoproxil, the liver function indexes(albumin [ALB], aspartate aminotransferase [AST], total bilirubin [TBiL]) level, liver stiffness, liver and spleen ultrasound indexes(portal vein diameter, splenic vein diameter and spleen thickness), negative rate of HBV-DNA and the incidence of adverse reactions during the treatment were compared between the two groups. Results After treatment, the levels of AST and TBiL in the two groups were lower than those before treatment, and the levels of ALB were higher than those before treatment, and the levels of AST and TBiL in the observation group were lower than those in the control group, and the levels of ALB were higher than those in the control group, and the differences were statistically significant(P<0.05). The spleen thickness was thinner than that of the control group, and the portal vein diameter, splenic vein diameter were shorter than those of the the control group, and the differences were statistically significant(P<0.05);after 12, 24 and 48 weeks of treatment, the negative rate of HBV-DNA in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group during treatment was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion The use of tenofovir disoproxil for rescue treatment of hepatitis B virus(HBV) infection with liver cirrhosis patients can effectively con

关 键 词：肝硬化 补救治疗 替诺福韦酯 乙型肝炎病毒 肝功能 

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