替诺福韦酯联合标准抗结核方案治疗初治肺结核合并慢性乙肝的临床疗效  

Clinical Efficacy of Tenofovir Disoproxil in Combination with Standard Anti-tuberculosis Regimen in the Treatment of Primary Tuberculosis Combined with Chronic Hepatitis B

作　　者：林宝勇 胡怀阳[1] 杨庆堂 LIN Baoyong;HU Huaiyang;YANG Qingtang(Department of Infectious Diseases,Hui'an County Hospital,Quanzhou,Fujian Province,362100 China;Depart-ment of Internal Medicine,Hui'an County Hospital of Traditional Chinese Medicine,Quanzhou,Fujian Province,362100 China)

机构地区：[1]惠安县医院感染性疾病科,福建泉州362100 [2]惠安县中医院内科,福建泉州362100

出　　处：《中外医疗》2023年第30期87-90,共4页China & Foreign Medical Treatment

摘　　要：目的探讨替诺福韦酯联合标准抗结核方案治疗初治肺结核合并慢性乙肝(chronic hepatitis B,CHB)的临床疗效。方法选择2018年1月—2021年1月惠安县医院收治的82例初治肺结核合并CHB患者为研究对象,按照随机数表法分为两组,每组41例。对照组予以恩替卡韦联合标准抗结核方案治疗,研究组予以替诺福韦酯联合标准抗结核方案治疗,比较两组患者的肺结核治疗转归、慢性乙肝治疗转归情况。结果两组患者痰菌转阴率、病灶吸收率、空洞改善及复发率比较,差异无统计学意义(P>0.05)。研究组病毒学应答率为95.12%与对照组的87.80%比较,差异无统计学意义(χ^(2)=0.525,P>0.05);研究组组织学应答率(90.24%)与对照组(85.37%)比较,差异无统计学意义(P>0.05)。两组患者对治疗药物总体耐受,均未发生CHB急性发作,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论肺结核合并CHD患者使用替诺福韦酯治疗既能抑制病毒复制,保护肝组织,又能提高机体对抗结核药物的耐受性,防止CHB急性发作,保证抗结核疗效,与恩替卡韦的效果相当。Objective To explore the clinical efficacy of tenofovir disoproxil combined with standard anti-tuberculosis regimen in the treatment of primary tuberculosis combined with chronic hepatitis B(CHB).Methods 82 newly diag⁃nosed pulmonary tuberculosis patients with CHB admitted to Hui'an County Hospital from January 2018 to January 2021 were selected as the research subjects.They were divided into two groups using a random number table method,with 41 patients in each group.The control group was treated with entecavir combined with standard antituberculosis regimen,and the study group was treated with tenofovir dipivoxil combined with standard antituberculosis regimen.The treatment outcomes of pulmonary tuberculosis and chronic hepatitis B were compared between the two groups.Results There was no statistically significant difference in the conversion rate of sputum bacteria to negative,lesion absorption rate,cavity improvement,and recurrence rate between the two groups(P>0.05).The virological response rate of the study group was 95.12%,and there was no statistically significant difference compared to the control group's 87.80%(χ^(2)=0.525,P>0.05);There was no statistically significant difference in the histological response rate between the study group(90.24%)and the control group(85.37%)(P>0.05).The overall tolerance of the two groups of patients to the treatment drugs was not affected,and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The use of tenofovir disoproxil treatment in patients with pulmonary tuberculosis combined with CHD can not only inhibit viral replication and protect liver tissue,but also improve the body's toler⁃ance to anti-tuberculosis drugs,prevent acute attack of CHB,and ensure the efficacy of anti-tuberculosis treatment,which is comparable to the effect of entecavir.

关 键 词：替诺福韦酯 抗结核 肺结核合并慢性乙肝 

分 类 号：R512[医药卫生—内科学]