恩替卡韦联合复方鳖甲软肝片治疗乙型肝炎肝衰竭的临床效果  

Clinical effect of entecavir combined with Compound Biejia Ruangan Tablet in the treatment of hepatitis B liver failure

作　　者：南然 席奇 刘永刚 宋春荣 NAN Ran;XI Qi;LIU Yonggang;SONG Chunrong(No.1 Ward,Hepatology Hospital,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西中医药大学附属医院肝病医院一病区,陕西咸阳712000

出　　处：《检验医学与临床》2023年第21期3105-3108,3113,共5页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划项目(2023-YBSF-343);陕西省中医管理局中医药科研课题(LCPT128);陕西省中医药大学校级科研课题(2020XK02)。

摘　　要：目的探讨恩替卡韦与复方鳖甲软肝片联合治疗乙型肝炎肝衰竭的临床效果。方法选取2019年8月至2021年8月陕西中医药大学附属医院肝病医院收治的乙型肝炎肝衰竭患者120例作为研究对象,并随机将其分为观察组和对照组,每组60例。对照组予以复方鳖甲软肝片进行治疗,观察组在对照组的基础上增加恩替卡韦进行治疗。对比两组患者的临床疗效、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]、免疫功能指标[CD40、CD80、组织相容性复合体Ⅱ类(MHC-Ⅱ)]、炎症因子[单核细胞趋化因子-1(MCP-1)、白细胞介素-6(IL-6)、高迁移率族蛋白B1(HMGB1)]水平和治疗安全性。结果观察组总有效率为93.33%(56/60),高于对照组的78.33%(47/60),差异有统计学意义(P<0.05)。治疗后观察组的ALT、AST、TBIL水平均低于对照组(P<0.05)。治疗后观察组的CD40、CD80、MHC-Ⅱ水平均高于对照组(P<0.05)。观察组治疗后的MCP-1、IL-6、HMGB1水平均低于对照组(P<0.05)。治疗期间观察组与对照组不良反应总发生率[13.33%(8/60)vs.8.33%(5/60)]比较,差异无统计学意义(P>0.05)。结论恩替卡韦与复方鳖甲软肝片联合治疗乙型肝炎肝衰竭效果良好,可改善患者ALT、AST、TBIL水平,降低MCP-1、IL-6、HMGB1水平,增强免疫功能,安全性高。Objective To study the clinical effect of entecavir combined with Compound Biejia Ruangan tablet in the treatment of hepatitis B liver failure.Methods From August 2019 to August 2021,120 patients with hepatitis B liver failure collected in the Hepatology Hospital,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were selected as the treatment objects,which were divided into observation group and control group,with 60 cases in each group.The control group was treated with Biejia Ruangan tablet,and the observation group was treated with entecavir on the basis of the control group.The clinical efficacy,liver function indexes alanine aminotransferase(ALT),aspartate amino transferase(AST)and total bilirubin(TBIL),immune function indexes CD40,CD80 and major histocompatibility complexⅡ(MHC-Ⅱ),inflammatory factors[monocyte chemoattractant protein-1(MCP-1)and interleukin-6(IL-6)and high mobility group protein B1(HMGB1)]levels and treatment safety of the two groups were compared.Results The total effective rate in the observation group[93.33%(56/60)]was higher than that in the control group[78.33%(47/60)]with statistically significant difference(P<0.05).The levels of ALT,AST and TBIL after treatment in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD40,CD80 and MHC-Ⅱin the observation group were higher than those in the control group(P<0.05).The levels of MCP-1,IL-6 and HMGB1 after treatment in the observation group were lower than those in the control group(P<0.05).The adverse effect rate in the observation group and the control group[13.33%(8/60)vs.8.33%(5/60)]had no statistical significant difference(P>0.05).Conclusion The combination of entecavir and Compound Biejia Ruangan tablet has a good effect in the treatment of hepatitis B liver failure,and it can improve the ALT,AST,TBIL levels of patients,reduce the levels of MCP-1,IL-6,HMGB1 and enhance immune function with good safety.

关 键 词：乙型肝炎肝衰竭 复方鳖甲软肝片 恩替卡韦 肝功能指标 炎症因子 

分 类 号：R575.3[医药卫生—消化系统]