恩替卡韦联合水飞蓟宾治疗乙肝合并非酒精性脂肪肝患者的临床疗效及对患者肝功能的影响  

Clinical Efficacy of Entecavir Combined with Silibinin in the Treatment of Hepatitis B Patients with Non-alcoholic Fatty Liver Disease and its Influence on Liver Function

作　　者：翟云峰 李秀荣 ZHAI Yunfeng;LI Xiurong(General Hospital of YongMei Group,Yongcheng Henan 476600)

机构地区：[1]永煤集团总医院,河南永城476600

出　　处：《医学临床研究》2024年第8期1216-1218,共3页Journal of Clinical Research

摘　　要：【目的】探讨恩替卡韦联合水飞蓟宾治疗乙型病毒性肝炎(CHB)合并非酒精性脂肪肝(NAFLD)患者的临床疗效及对患者肝功能的影响。【方法】选取2021年6月至2023年1月本院收治的104例CHB合并NAFLD患者,根据治疗方法将其分为对照组(在常规治疗的基础上给予恩替卡韦治疗)和观察组(在对照组的基础上给予水飞蓟宾治疗),每组52例。比较两组临床效果、肝功能[丙转氨酶(ALT)、谷草转氨酶(AST)、肿瘤标志物甲胎蛋白(AFP)]、肝纤维化指标[层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、核因子-κB(NF-κB)]。【结果】观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组ALT、AST、AFP低于治疗前,且观察组低于对照组(P<0.05);两组血清LN、PC-Ⅲ、Ⅳ-C、HA水平低于治疗前,且观察组低于对照组(P<0.05);两组血清IL-6、TNF-α、NF-κB水平低于治疗前,且观察组低于对照组(P<0.05)。【结论】恩替卡韦联合水飞蓟宾治疗CHB合并NAFLD患者可改善肝功能,减轻机体炎症反应,缓解肝纤维化进展。【Objectives】To investigate the clinical efficacy of entecavir combined with silibinin in the treatment of patients with viral hepatitis B(CHB)complicated with non-alcoholic fatty liver disease(NAFLD)and its impact on liver function.【Methods】A total of 104 patients with CHB and NAFLD admitted to our hospital from June 2021 to January 2023 were selected and divided into the control group(treated with entecavir in addition to conventional treatment)and the observation group(treated with silibinin in addition to conventional treatment)according to the treatment method,with 52 patients in each group.Two groups were compared in terms of clinical efficacy,liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),tumor marker alpha fetoprotein(AFP)],liver fibrosis indicators[laminin(LN),typeⅢprocollagen(PC-Ⅲ),typeⅣcollagen(Ⅳ-C),hyaluronic acid(HA)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),nuclear factor kappa B(NF-κB)].【Results】The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,ALT,AST,and AFP levels in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05);The serum levels of LN,PC-Ⅲ,Ⅳ-C,and HA in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05);The serum levels of IL-6,TNF-α,and NF-κB in both groups were lower than before treatment,and the observation group was lower than the control group(P<0.05).【Conclusion】The combination of entecavir and silibinin in the treatment of CHB patients with NAFLD can improve liver function,reduce inflammatory response,and alleviate the progression of liver fibrosis.

关 键 词：非酒精性脂肪性肝病 水飞蓟素 治疗结果 肝功能试验 

分 类 号：R575[医药卫生—消化系统]