恩替卡韦联合前列地尔治疗慢性乙型肝炎并发肝硬化腹水的效果分析  

Therapeutic effect of entecavir combined with alprostadil in the treatment of chronic hepatitis B complicated by cirrhosis and hepatic ascites

作　　者：刘伟伟[1] 史晓玉 王乐[1] 徐琳娟 Liu Weiwei;Shi Xiaoyu;Wang Le;Xu Linjuan(Department of Infectious Diseases,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院感染性疾病科,郑州450000

出　　处：《中国实用医刊》2024年第12期76-79,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨恩替卡韦与前列地尔对慢性乙型肝炎并肝硬化腹水的治疗效果。方法队列研究。抽取2020年6月至2023年6月郑州大学第一附属医院收治的慢性乙型肝炎并肝硬化腹水患者101例,按随机数字表法分为对照组(50例)和观察组(51例)。对照组采用恩替卡韦治疗,观察组采用恩替卡韦联合前列地尔治疗。比较两组临床疗效,比较两组治疗前后肝功能指标[总胆红素(TBiL)、直接胆红素(DBiL)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)]、肾功能指标[尿素氮(BUN)、β2-微球蛋白(β2-MG)、血肌酐(SCr)]及炎症因子[B细胞活化因子受体(BAFF-R)、肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)]水平;比较两组不良反应发生率。结果观察组总有效率(90.20%,46/51)高于对照组(74.00%,37/50),P<0.05。治疗后,观察组TBiL、DBiL、γ-GT、TBA水平均低于对照组(P均<0.05);治疗后,观察组BAFF-R、IL-6、TNF-α水平均低于对照组(P均<0.05);治疗后,观察组BUN、β2-MG、SCr水平均低于对照组(P均<0.05)。观察组不良反应发生率(9.80%,5/51)与对照组(8.00%,4/50)比较,差异未见统计学意义(P>0.05)。结论前列地尔辅助恩替卡韦治疗慢性乙型肝炎合并肝硬化腹水的效果良好,能提升肝功能、肾功能,降低炎症因子水平,安全性较好。Objective To investigate the clinical efficacy of entecavir combined with alprostadil in the treatment of chronic hepatitis B complicated by cirrhosis and hepatic ascites.Methods A cohort study was adopted in this study.A total of 101 patients with chronic hepatitis B complicated by cirrhosis and hepatic ascites admitted to the First Affiliated Hospital of Zhengzhou University from June 2020 to June 2023 were selected,and they were divided into a control group(50 cases)and an observation group(51 cases)by random number table method.The control group was treated with entecavir,while the observation group was treated with entecavir combined with alprostadil.The clinical efficacy of two groups were compared.The levels of liver function indicators,including total bilirubin(TBiL),direct bilirubin(DBiL),γ-glutamyl transferase(γ-GT)and total bile acid(TBA),renal function indicators,including blood urea nitrogen(BUN),β2-microglobulin(β2-MG)and serum creatinine(SCr),and inflammatory factors,including B-cell activating factor of the tumor necrosis factor family receptor(BAFF-R),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),were compared between two groups before and after treatment.The incidence of adverse reactions of the two groups were compared.Results The total effective rate of the observation group(90.20%,46/51)was higher than that of the control group(74.00%,37/50),P<0.05.After treatment,the levels of TBiL,DBiL,γ-GT,and TBA in the observation group were lower than those in the control group(all P<0.05).After treatment,the levels of BAFF-R,IL-6 and TNF-αin the observation group were lower than those in the control group(all P<0.05).After treatment,the levels of BUN,β2-MG,SCr in the observation group were lower than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(9.80%,5/51)and the control group(8.00%,4/50),P>0.05.Conclusions Entecavir combined with alprostadil has a good therapeutic effect on chronic hepati

关 键 词：慢性乙型肝炎 肝腹水 恩替卡韦 前列地尔 临床疗效 

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