恩替卡韦单药与联合益生菌治疗乙型肝炎肝硬化的疗效及安全性分析  

Efficacy of entecavir alone and combined with probiotics in the treatment of hepatitis B cirrhosis and analysis of safety

作　　者：王妍[1] 付成涛 王建[2] 高远征[1] Wang Yan;Fu Chengtao;Wang Jian;Gao Yuanzheng(Department of Infectious Diseases,Binzhou Central Hospital,Binzhou 251700,China;Department of Laboratory,Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]滨州市中心医院感染性疾病科,滨州251700 [2]滨州市中心医院检验科,滨州251700

出　　处：《中国医师进修杂志》2025年第4期365-369,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析在乙型肝炎肝硬化治疗中应用恩替卡韦单一治疗和恩替卡韦联合益生菌治疗的疗效和安全性。方法前瞻性选择滨州市中心医院2020年5月至2022年5月诊治的88例乙型肝炎肝硬化患者为研究对象,按随机数字表法分为对照组(44例)和观察组(44例),对照组给予恩替卡韦单一治疗,观察组给予恩替卡韦联合益生菌治疗,比较两组治疗前后的肠道菌群情况、血氨(BUN)及肝功能指标和肝纤维化四项指标水平,并比较两组治疗3个月后的临床疗效和治疗期间不良反应发生情况。结果观察组治疗后有害菌/有益菌比例、BUN、总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷氨酰转移酶及Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白和透明质酸酶水平低于对照组[(10.52±1.35)%比(11.38±2.19)%、(70.26±6.94)μmol/L比(76.34±10.59)μmol/L、(32.76±4.27)μmol/L比(36.82±6.41)μmol/L、(51.82±6.37)U/L比(56.34±5.74)U/L、(37.83±5.61)U/L比(42.75±12.89)U/L、(42.67±11.84)U/L比(48.16±13.49)U/L、(118.76±23.65)μg/L比(129.24±21.16)μg/L、(74.34±17.58)μg/L比(82.39±20.05)μg/L、(127.65±12.23)mg/L比(138.97±11.76)mg/L、(107.78±23.47)mg/L比(119.65±22.35)mg/L],差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组、不良反应发生率低于对照组[88.64%(39/44)比70.45%(31/44)、4.55%(2/44)比18.18%(8/44)],差异有统计学意义(χ^(2)=4.47、4.06,P<0.05)。结论在乙型肝炎肝硬化患者治疗中,恩替卡韦联合益生菌可有效调节胃肠道功能,降低BUN水平,进而更利于肝功能恢复,减轻肝纤维化进程,提高疗效,且可减少不良反应的发生。ObjectiveTo analysis of the efficacy and safety of entecavir monotherapy and entecavir combined with probiotic therapy in the treatment of hepatitis B cirrhosis.MethodsA total of 88 patients with hepatitis B cirrhosis diagnosed and treated in Binzhou Central Hospital from May 2020 to May 2022 were prospectively selected as the study objects,and divided into the control group(44 cases)and the observation group(44 cases)according to random number table method.The control group was given entecavir monotherapy,and the observation group was given entecavir combined with probiotics.The levels of intestinal flora,blood ammonia(BUN),liver function index and liver fibrosis were compared between the two groups before and after treatment,and the clinical efficacy after 3 months of treatment and the occurrence of adverse reactions during treatment were compared between the two groups.ResultsAfter treatment,the ratio of harmful/beneficial bacteria,serum BUN,total bilirubin(TBIL),alanine aminotransferase(ALT),azelaic aminotransferase(AST),glutamyltransferase(GGT),pre-collagen typeⅢ(PCⅢ),collagen typeⅣ(Ⅳ-C),laminin(LN),and hyaluronidase(HA)in the observation group were lower than those in the control group:(10.52±1.35)%vs.(11.38±2.19)%,(70.26±6.94)μmol/L vs.(76.34±10.59)μmol/L,(32.76±4.27)μmol/L vs.(36.82±6.41)μmol/L,(51.82±6.37)U/L vs.(56.34±5.74)U/L,(37.83±5.61)U/L vs.(42.75±12.89)U/L,(42.67±11.84)U/L vs.(48.16±13.49)U/L,(118.76±23.65)μg/L vs.(129.24±21.16)μg/L,(74.34±17.58)μg/L vs.(82.39±20.05)μg/L,(127.65±12.23)mg/L vs.(138.97±11.76)mg/L,(107.78±23.47)mg/L vs.(119.65±22.35)mg/L,there were statistical differences(P<0.05).During the 3-month treatment period,the total effective rate in the observation group was higher than that in the control group and the total incidence of adverse reactions was lower than that in the control group:88.64%(39/44)vs.70.45%(31/44),4.55%(2/44)vs.18.18%(8/44),there were statistical differences(χ^(2)=4.47,4.06,P<0.05).ConclusionsIn the treatment of hepatitis B c

关 键 词：乙型肝炎 肝硬化 恩替卡韦 益生菌 

分 类 号：R575.2[医药卫生—消化系统]