恩替卡韦联合复方嗜酸乳杆菌治疗慢性乙型肝炎肝纤维化患者的疗效  

Efficacy of entecavir combined with compound lactobacillus acidophilus in the treatment of patients with chronic hepatitis B and liver fibrosis

作　　者：宋妹 赵越越 王丽欢 高晨 SONG Mei;ZHAO Yueyue;WANG Lihuan;GAO Chen(Medical School,Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053,China;Department of Infectious Diseases,Jiashan Branch of the Second Affiliated Hospital of Zhejiang University School of Medicine,Jiaxing 314100,Zhejiang Province,China)

机构地区：[1]浙江中医药大学医学院,杭州310053 [2]浙江大学医学院附属第二医院嘉善分院感染科,浙江嘉兴314100

出　　处：《药学前沿》2025年第4期617-623,共7页China Pharmacist

基　　金：嘉善县科技局项目(2019A42)。

摘　　要：目的探讨恩替卡韦联合复方嗜酸乳杆菌片(CELT)治疗慢性乙型肝炎(CHB)肝纤维化患者的疗效。方法回顾性分析2020年1月至2024年1月浙江大学医学院附属第二医院嘉善分院感染科诊疗的CHB肝纤维化患者的临床资料。根据治疗方案将患者分为观察组(恩替卡韦联合CELT治疗)和对照组(恩替卡韦单药治疗)。采用1∶1倾向得分匹配(PSM)平衡组间基线特征。观察两组治疗总有效率、肝功能指标[总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和白蛋白(Alb)]、肝纤维化指标[肝纤维化指标包括透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(IV-C)]、病毒载量指标(HBV-DNA转阴率和HBsAg转阴率)、炎性指标(CRP和IL-6)。结果共纳入401例患者,经PSM匹配后,每组各纳入122例患者。观察组总有效率显著高于对照组(87.70%vs.77.87%,P<0.05)。治疗3个月和6个月后,观察组CHB肝纤维化患者HA、LN、PC-III、IV-C、TBil、ALT、AST、IL-6、CRP、HBV-DNA和HBsAg水平显著低于对照组(P<0.05),而Alb水平显著高于对照组(P<0.05)。观察组HBV转阴率(63.93%vs.40.16%,P<0.05)和HBsAg转阴率(62.30%vs.36.89%,P<0.05)显著高于对照组。两组不良反应总发生率差异无统计学意义(P>0.05)。结论恩替卡韦联合CELT可提高CHB肝纤维化患者治疗总有效率,抑制肝纤维化,改善肝功能,减轻炎症反应,减少病毒载量促进转阴。Objective To investigate the efficacy of entecavir combined with compound eosinophil-lactobacillus tablets(CELT)in the treatment of patients with liver fibrosis due to chronic hepatitis B(CHB).Methods The clinical data of patients with liver fibrosis due to CHB who were treated in the Department of Infectious Diseases,Jiashan Branch,The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to January 2024 were retrospectively analyzed.According to the treatment plan,the patients were divided into an observation group(entecavir combined with CELT treatment)and a control group(entecavir monotherapy).1∶1 Propensity Score Matching(PSM)was used to balance the baseline characteristics between the two groups.The total effective rate,liver function indicators(TBil,ALT,AST and Alb),liver fibrosis indicators(HA,LN,PC-Ⅲand IV-C),viral load indicators(HBV-DNA negative conversion rate and HBsAg negative conversion rate),and inflammatory indicators(CRP and IL-6)were observed between the two groups.Results A total of 401 patients were included.After PSM matching,122 patients were included in each group.The total effective rate of the observation group was significantly higher than that of the control group(87.70%vs.77.87%,P<0.05).After 3 months and 6 months of treatment,the levels of HA,LN,PC-III,IV-C,TBil,ALT,AST,IL-6,CRP,HBV-DNA and HBsAg in the observation group were significantly lower than those in the control group(P<0.05),while the level of Alb was significantly higher than that in the control group(P<0.05).The HBV negative conversion rate(63.93%vs.40.16%,P<0.05)and HBsAg negative conversion rate(62.30%vs.36.89%,P<0.05)in the observation group were significantly higher than those in the control group.There was no significant difference in the total incidence of adverse reactions between the two groups(P﹥0.05).Conclusion Entecavir combined with CELT can improve the total effective rate of CHB patients with liver fibrosis,inhibit liver fibrosis,improve liver function,alleviate inflamm

关 键 词：复方嗜酸乳杆菌片 慢性乙肝肝硬化 炎症因子 疗效 

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