CAJ | 학술논문

目的：评价抗结核同时给予恩替卡韦治疗慢性乙型肝炎合并肺结核的临床疗效。方法64例服用抗结核药物的肺结核合并慢性乙型肝炎患者以同等病情匹配的原则分为治疗组和对照组。治疗组在应用2DTLFXE/4DT抗结核和常规保肝药物的同时，服用恩替卡韦分散片0.5mg，每日1次，疗程6个月。对照组仅应用抗结核和常规保肝药物，剂量和疗程同治疗组。评价治疗前后患者肝功能、HBV DNA水平、痰菌转阴及肺部病灶吸收情况。结果治疗后治疗组肝损伤3.125％(1/32)和28.13％(9/32)，其差异有统计学意义（P<0.01），其HBV-DNA转阴率或下降率、痰菌转阴率及肺部病灶吸收率均明显好于对照组，分别为75％与12.5％、96.88％与71.88％、93.78％与65.63％（P<0.01）。结论恩替卡韦可减少慢性乙型肝炎合并肺结核患者应用抗结核药物所致的肝损伤，安全性好。
목적：평개항결핵동시급여은체잡위치료만성을형간염합병폐결핵적림상료효。방법64례복용항결핵약물적폐결핵합병만성을형간염환자이동등병정필배적원칙분위치료조화대조조。치료조재응용2DTLFXE/4DT항결핵화상규보간약물적동시，복용은체잡위분산편0.5mg，매일1차，료정6개월。대조조부응용항결핵화상규보간약물，제량화료정동치료조。평개치료전후환자간공능、HBV DNA수평、담균전음급폐부병조흡수정황。결과치료후치료조간손상3.125％(1/32)화28.13％(9/32)，기차이유통계학의의（P<0.01），기HBV-DNA전음솔혹하강솔、담균전음솔급폐부병조흡수솔균명현호우대조조，분별위75％여12.5％、96.88％여71.88％、93.78％여65.63％（P<0.01）。결론은체잡위가감소만성을형간염합병폐결핵환자응용항결핵약물소치적간손상，안전성호。
Objective It is purposed to evaluate clinical efficacy of entecavir combined with anti-tuberculosis (TB) drugs in treatment for chronic hepatitis B(CHB) complicated with pulmonary TB.Methods Sixty-four cases of pulmonary TB complicated with CHB receiving anti-TB drug treatment divided into treatment(32 cases) and control groups(32 cases).The treatment group were administered with 2DTLFXE/4DT and regular liver-protection drugs,as well as oral entecavir 0.5mg daily for six months,and another 32 cases in the control group were administered with the same anti-TB and regular liver-protection drugs as the treatment group.Before and after treatment,liver function,serum HBV DNA level,sputum negative conversion rate,and absorption of pulmonary TB lesion were evaluated.Results After treatment,the incidence rate of liver injury aggravation was 3.125%,as compared to that in 28.13% of the control group(P<0.01).HBV-DNA conversed to negative or went down (48.9%),sputum conversed to negative in (96.88%)and pulmonary lesion absorbed in (93.78%),all with statistically significance as compared to those in the control group(12.5%,71.88%and 65.63%,respectively,P<0.01).Conclusion Entecavir has a good safety and can reduce liver damage in anti-TB drug treatment for patients of CHB complicated with pulmonary TB.