双歧杆菌三联活菌联合恩替卡韦对乙型肝炎肝硬化患者ALT水平和HBeAg血清学转换率及HBV-DNA载量的影响  

Effect of live combined bifidobacterium, lactobacillus and enterococcus combined with entecavir on ALT level, HBeAg seroconversion rate and HBV-DNA load in patients with hepatitis B cirrhosis

作　　者：邱小琴 QIU Xiaoqin(Department of Gastroenterology,Xishui Hospital Affiliated to Hubei University of science and technology,Hubei province,Xishui 438200,China)

机构地区：[1]湖北科技学院附属浠水医院消化内科,湖北省浠水县438200

出　　处：《临床合理用药杂志》2024年第4期14-17,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察双歧杆菌三联活菌联合恩替卡韦对乙型肝炎肝硬化患者和丙氨酸氨基转移酶(ALT)水平、乙型肝炎E抗原(HBeAg)血清学转换率及HBV-DNA载量的影响。方法 选取2017年3月—2019年3月湖北科技学院附属浠水医院收治的乙型肝炎肝硬化患者122例,根据随机数字表法分为试验组和对照组,各61例。对照组予恩替卡韦分散片治疗,试验组在对照组基础上予双歧杆菌三联活菌胶囊治疗,2组均治疗6个月。比较2组肝功能指标[ALT、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)]、HBeAg血清学转换率、HBV-DNA载量、生活质量评分、肠道菌群分布及不良反应。结果 治疗6个月后,2组ALT、AST、TBil水平较治疗前降低,且试验组低于对照组(P<0.01)。治疗12、24周,2组HBeAg血清学转换率比较差异无统计学意义(P>0.05);治疗48周,试验组HBeAg血清学转换率高于对照组(P<0.05)。治疗6个月后,2组HBV-DNA载量较治疗前降低,且试验组低于对照组(P<0.01);2组生理功能、情感职能、精神健康、躯体疼痛评分组内、组间比较差异无统计学意义(P>0.05);2组生理职能、社会功能、活力及总体健康评分较治疗前升高,且试验组生理职能、活力及总体健康评分高于对照组(P<0.05或P<0.01),社会功能评分组间比较差异无统计学意义(P>0.05);2组乳杆菌、双歧杆菌高于治疗前,肠杆菌、肠球菌、梭菌低于治疗前,且试验组变化幅度大于对照组(P<0.01)。试验组与对照组不良反应总发生率比较差异无统计学意义(8.20%vs. 6.56%,P=1.000)。结论 双歧杆菌三联活菌联合恩替卡韦治疗乙型肝炎肝硬化,可改善患者ALT、AST、TBil水平,提高HBeAg血清学转换率,降低HBV-DNA载量,改善患者生活质量,且不会明显增加不良反应。Objective To observe the effect of live combined bifidobacterium、lactobacillus and enterococcus combined with entecavir on ALT level,HBeAg seroconversion rate and HBV-DNA load in patients with hepatitis B cirrhosis.Methods A total of 122 patients with hepatitis B cirrhosis admitted to Xishui Hospital Affiliated to Hubei University of science and technology from March 2017 to March 2019 were selected and randomly divided into experimental group and control group,with 61 cases in each group.The control group was treated with entecavir dispersible tablets,and the experimental group was treated with live combined bifidobacterium、lactobacillus and enterococcus capsules on the basis of the control group.Both groups were treated for 6 months.The liver function indexes(ALT,AST,TBil),HBeAg seroconversion rate,HBV-DNA load,quality of life score,intestinal flora distribution and adverse reactions were compared between the two groups.Results After 6 months of treatment,the levels of ALT,AST and TBil in the two groups were lower than those before treatment,and the levels in the experimental group were lower than those in the control group(P<0.01).There were no significant differences in HBeAg seroconversion rate between the two groups at 12 and 24 weeks of treatment(P>0.05).After 48 weeks of treatment,the HBeAg seroconversion rate in the experimental group was higher than that in the control group(P<0.05).After 6 months of treatment,the HBV-DNA loads in the two groups were decreased compared with those before treatment,and the experimental group was lower than the control group(P<0.01).There was no significant difference in physical function,emotional function,mental health,physical pain scores between the two groups(P>0.05).The scores of physiological function,social function,vitality and general health of the two groups were higher than those before treatment,and the scores of physiological function,vitality and general health of the experimental group were higher than those of the control group(P<0.05 or P<0.01).There

关 键 词：乙型肝炎 肝硬化 双歧杆菌三联活菌 恩替卡韦 ALT HBeAg血清学转换率 HBV-DNA 

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