中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2013年
5期
674-677
,共4页
洪友志%郑瑞丹%黄记水%郑佩星%陈建能%江涛源%卢燕辉
洪友誌%鄭瑞丹%黃記水%鄭珮星%陳建能%江濤源%盧燕輝
홍우지%정서단%황기수%정패성%진건능%강도원%로연휘
恩替卡韦%结核,肺%肝炎,乙型%肝损害%临床观察
恩替卡韋%結覈,肺%肝炎,乙型%肝損害%臨床觀察
은체잡위%결핵,폐%간염,을형%간손해%림상관찰
Entecavir%Tuberculosis,pulmonary%Hepatitis B%Liver damage%Clinical observation
目的：探讨恩替卡韦对减轻肺结核并乙型肝炎患者抗结核药肝损害的作用。方法提前干预及与抗结核药物同步治疗及单纯抗结核药物治疗3组对比观察。结果3组患者中，提前干预组发生肝损害发生率为10.7%（3/28），同步治疗组发生率为18.2%（6/33），单纯抗结核组发生率为51.4%（18/35），3组间差异具有统计学意义（χ2=15.215，P ＜0.01）。3组患者两两比较发现，提前干预组和同步治疗组肝损害发生率均明显低于单纯抗结核组（χ2=11.604，P ＜0.01；χ2=8.221，P＜0.01），但提前干预组与同步治疗组肝损害发生率差异无统计学意义（χ2=0.000，P ＞0.05）。单纯抗结核组临床症状及肝损害发生率高，其肝功能恢复时间长且部分患者无法完成抗结核治疗。结论提前干预及与抗结核药物同步治疗对比单纯抗结核药物治疗，提前干预组肝损害发生率低，化疗完成率高，建议对肺结核患者合并乙型肝炎者提前使用恩替卡韦再进行抗结核治疗。
目的：探討恩替卡韋對減輕肺結覈併乙型肝炎患者抗結覈藥肝損害的作用。方法提前榦預及與抗結覈藥物同步治療及單純抗結覈藥物治療3組對比觀察。結果3組患者中，提前榦預組髮生肝損害髮生率為10.7%（3/28），同步治療組髮生率為18.2%（6/33），單純抗結覈組髮生率為51.4%（18/35），3組間差異具有統計學意義（χ2=15.215，P ＜0.01）。3組患者兩兩比較髮現，提前榦預組和同步治療組肝損害髮生率均明顯低于單純抗結覈組（χ2=11.604，P ＜0.01；χ2=8.221，P＜0.01），但提前榦預組與同步治療組肝損害髮生率差異無統計學意義（χ2=0.000，P ＞0.05）。單純抗結覈組臨床癥狀及肝損害髮生率高，其肝功能恢複時間長且部分患者無法完成抗結覈治療。結論提前榦預及與抗結覈藥物同步治療對比單純抗結覈藥物治療，提前榦預組肝損害髮生率低，化療完成率高，建議對肺結覈患者閤併乙型肝炎者提前使用恩替卡韋再進行抗結覈治療。
목적：탐토은체잡위대감경폐결핵병을형간염환자항결핵약간손해적작용。방법제전간예급여항결핵약물동보치료급단순항결핵약물치료3조대비관찰。결과3조환자중，제전간예조발생간손해발생솔위10.7%（3/28），동보치료조발생솔위18.2%（6/33），단순항결핵조발생솔위51.4%（18/35），3조간차이구유통계학의의（χ2=15.215，P ＜0.01）。3조환자량량비교발현，제전간예조화동보치료조간손해발생솔균명현저우단순항결핵조（χ2=11.604，P ＜0.01；χ2=8.221，P＜0.01），단제전간예조여동보치료조간손해발생솔차이무통계학의의（χ2=0.000，P ＞0.05）。단순항결핵조림상증상급간손해발생솔고，기간공능회복시간장차부분환자무법완성항결핵치료。결론제전간예급여항결핵약물동보치료대비단순항결핵약물치료，제전간예조간손해발생솔저，화료완성솔고，건의대폐결핵환자합병을형간염자제전사용은체잡위재진행항결핵치료。
Objective To evaluate the treatment outcomes of entecavir reducing liver damage of pulmonary tuberculosis patients with hepatitis B after administration of anti-tuberculosis medications. Methods All pulmonary TB patients were randomly divided into three groups. The group received 0.5 mg entecavir before anti-TB treatment (group A). The group received 0.5 mg entecavir together with anti-TB treatment (group B). The group received simple anti-TB treatment (group C), the liver damage of patients in the three groups after treatment were observed. Results The group A had 3 cases who had liver damage, the incidence rate was 10.7% (3/28). The group B had 6 cases, the incidence rate was 18.2% (6/33). The group C had 18 cases, the incidence rate was 51.4% (18/35). The difference of the three groups was statistically significant (χ 2 = 15.215,P < 0.01). In Comparison between two groups, the incidence rate of liver damage of the first two groups (the group A and the group B) was significantly lower than that of the group C (χ 2 =11.604,P < 0.01;χ 2 = 8.221,P < 0.01), but the group A and the group B had no statistical difference (χ 2= 0.000,P > 0.05) in the incidence rate of liver damage. The patients of the group C had a high incidence rate of clinical symptoms and liver damage and needed a long time to recover liver function, even some patients can not complete the anti-TB treatment. Conclusions Entecavir therapy can improve TB treatment success among pulmonary tuberculosis patients with hepatitis B. Therefore we recommend that the pulmonary tuberculosis patients with hepatitis B use entecavir for prophylaxis before receiving anti-TB therapy.
