抗病毒治疗对乙肝患者抗结核药物肝损伤的影响研究  

Effect of Antiviral Therapy on Liver Injury Caused by Anti-tuberculosis Drugs in Patients with Hepatitis B

作　　者：高阳[1] GAO Yang(Department of Internal Medicine,Heze Infectious Disease Hospital,Heze,Shandong Province,274000 China)

机构地区：[1]山东省菏泽市传染病医院内科,山东菏泽274000

出　　处：《中外医疗》2023年第11期138-141,共4页China & Foreign Medical Treatment

摘　　要：目的评估对乙肝肺结核患者行抗病毒治疗对抗结核药物肝损伤的影响。方法方便选择2021年6月—2022年6月山东省菏泽市传染病医院收治的62例乙肝肺结核患者为研究对象,按照随机数表法分为基础组和调查组,每组31例,基础组行基础抗结核治疗,调查组在基础抗结核治疗上增加抗病毒治疗。检测对比两组肝功能、乙肝病毒基因(HBV-DNA)指标、肝损伤情况、免疫功能。结果治疗后,调查组的丙氨酸转氨酶(ALT)(55.03±4.28)U/L、总胆红素(TBIL)(15.44±1.80)μmol/L、天冬氨酸氨基转氨酶(AST)(46.23±4.01)U/L均低于基础组,差异有统计学意义(t=8.220、4.619、6.671,P<0.001)。治疗后,调查组不同时间点的HBVDNA均低于基础组,差异有统计学意义(P<0.001)。调查组肝损伤恢复时间(14.23±1.88)d短于基础组,差异有统计学意义(t=15.137,P<0.05)。调查组肝损伤轻度率25.81%低于基础组的58.06%,差异有统计学意义(P<0.05)。结论抗病毒方案有较好价值,能减少肝损伤事件,降低肝损伤程度,加速肝损伤的恢复,有利于改善肝脏功能,可在乙肝肺结核的治疗中推广使用。Objective To evaluate the effects of anti-tuberculosis drugs on liver injury in hepatitis B pulmonary tuberculosis patients.Methods A total of 62 patients with hepatitis B pulmonary tuberculosis who were anmitted to Heze Infectious Disease Hospital of Shandong Province from June 2021 to June 2022 were conveniently selected as the research objects.According to the random number table method,they were divided into the basic group and the investigation group,31 cases in each group.The basic group received basic anti-tuberculosis treatment,and the investigation group increased antiviral treatment on the basis of basic anti-tuberculosis treatment.The liver function,HBVDNA index,liver injury and immune function of the two groups were detected and compared.Results After treatment,alanine aminotransferase(ALT)(55.03±4.28)U/L,total bilirubin(TBIL)(15.44±1.80)μmol/L,aspartate aminotransferase(AST)(46.23±4.01)U/L in the investigation group were lower than the basic group,the difference was statistically significant(t=8.220,4.619,6.671,P<0.001).After treatment,the HBV-DNA of the investigation group at different time points was lower than that of the basic group,and the difference was statistically significant(P<0.001).The recovery time of liver injury in the investigation group(14.23±1.88)d was shorter than that in the basic group,and the difference was statistically significant(t=15.137,P<0.05).The mild rate of liver injury in the investigation group(25.81%)was lower than that in the basic group(58.06%),and the difference was statistically significant(P<0.05).Conclusion Antiviral program has good value,can reduce the event of liver injury,reduce the degree of liver injury,accelerate the recovery of liver injury,improve liver function,can be widely used in the treatment of hepatitis B tuberculosis.

关 键 词：肝损伤 抗结核 免疫功能 抗病毒 使用价值 乙型肝炎 

分 类 号：R4[医药卫生—临床医学]