中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2014年
3期
235-238
,共4页
胡启江%徐美华%汪亮%侯光华%杜祥兵%张鸿%李敏%汪慧兰
鬍啟江%徐美華%汪亮%侯光華%杜祥兵%張鴻%李敏%汪慧蘭
호계강%서미화%왕량%후광화%두상병%장홍%리민%왕혜란
肝炎病毒,乙型%结核,肺%抗结核药%药物性肝损伤%替比夫定
肝炎病毒,乙型%結覈,肺%抗結覈藥%藥物性肝損傷%替比伕定
간염병독,을형%결핵,폐%항결핵약%약물성간손상%체비부정
Hepatitis B virus%Tuberculosis,pulmonary%Antitubercular agents%Drug-induced liver injury%Telbivudine
目的 观察替比夫定在HBV DNA阳性慢性HBV感染合并肺结核患者抗结核治疗过程中减轻肝损害的作用.方法 选择2011年6月至2013年12月武汉市黄陂区人民医院收治的HBV DNA阳性慢性HBV感染合并肺结核患者68例.按数字表法将所有患者随机分为2组,联合治疗组(35例)在抗结核治疗的同时给予替比夫定抗病毒治疗,单纯抗结核治疗组(33例)仅接受抗结核治疗.采用x2检验或秩和检验比较两组患者接受抗结核治疗后肝损害的发生率、调整或中止抗结核治疗率及HBV再激活率.结果 联合治疗组有5例(5/35,14.29％)患者发生肝损害,而单纯抗结核治疗组有15例(15/33,45.45％)患者发生肝损害,两组比较差异有统计学意义(x2=7.95,P＜0.05).联合治疗组有1例(1/35,2.86％)调整抗结核治疗方案,而单纯抗结核治疗组有13例(13/33,39.39％)调整或中止抗结核治疗,两组比较差异有统计学意义(x2=13.87,P＜0.01).联合治疗组有2例(2/35,5.71％)患者发生HBV再激活,而单纯抗结核治疗组有10例(10/33,30.30％)患者发生HBV再激活,两组HBV再激活率比较差异也有统计学意义(x2=7.34,P＜0.01).结论 替比夫定在HBV DNA阳性慢性HBV感染合并肺结核患者抗结核治疗中减轻肝损害有一定的作用.
目的 觀察替比伕定在HBV DNA暘性慢性HBV感染閤併肺結覈患者抗結覈治療過程中減輕肝損害的作用.方法 選擇2011年6月至2013年12月武漢市黃陂區人民醫院收治的HBV DNA暘性慢性HBV感染閤併肺結覈患者68例.按數字錶法將所有患者隨機分為2組,聯閤治療組(35例)在抗結覈治療的同時給予替比伕定抗病毒治療,單純抗結覈治療組(33例)僅接受抗結覈治療.採用x2檢驗或秩和檢驗比較兩組患者接受抗結覈治療後肝損害的髮生率、調整或中止抗結覈治療率及HBV再激活率.結果 聯閤治療組有5例(5/35,14.29％)患者髮生肝損害,而單純抗結覈治療組有15例(15/33,45.45％)患者髮生肝損害,兩組比較差異有統計學意義(x2=7.95,P＜0.05).聯閤治療組有1例(1/35,2.86％)調整抗結覈治療方案,而單純抗結覈治療組有13例(13/33,39.39％)調整或中止抗結覈治療,兩組比較差異有統計學意義(x2=13.87,P＜0.01).聯閤治療組有2例(2/35,5.71％)患者髮生HBV再激活,而單純抗結覈治療組有10例(10/33,30.30％)患者髮生HBV再激活,兩組HBV再激活率比較差異也有統計學意義(x2=7.34,P＜0.01).結論 替比伕定在HBV DNA暘性慢性HBV感染閤併肺結覈患者抗結覈治療中減輕肝損害有一定的作用.
목적 관찰체비부정재HBV DNA양성만성HBV감염합병폐결핵환자항결핵치료과정중감경간손해적작용.방법 선택2011년6월지2013년12월무한시황피구인민의원수치적HBV DNA양성만성HBV감염합병폐결핵환자68례.안수자표법장소유환자수궤분위2조,연합치료조(35례)재항결핵치료적동시급여체비부정항병독치료,단순항결핵치료조(33례)부접수항결핵치료.채용x2검험혹질화검험비교량조환자접수항결핵치료후간손해적발생솔、조정혹중지항결핵치료솔급HBV재격활솔.결과 연합치료조유5례(5/35,14.29％)환자발생간손해,이단순항결핵치료조유15례(15/33,45.45％)환자발생간손해,량조비교차이유통계학의의(x2=7.95,P＜0.05).연합치료조유1례(1/35,2.86％)조정항결핵치료방안,이단순항결핵치료조유13례(13/33,39.39％)조정혹중지항결핵치료,량조비교차이유통계학의의(x2=13.87,P＜0.01).연합치료조유2례(2/35,5.71％)환자발생HBV재격활,이단순항결핵치료조유10례(10/33,30.30％)환자발생HBV재격활,량조HBV재격활솔비교차이야유통계학의의(x2=7.34,P＜0.01).결론 체비부정재HBV DNA양성만성HBV감염합병폐결핵환자항결핵치료중감경간손해유일정적작용.
Objective To investigate the alleviation effect of telbivudine on liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection.Methods A total of 68 pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection were enrolled from Huangpi People' s Hospital during June 2011 and December 2013.Patients were randomly assigned to receive antitubercular plus telbivudine treatment (combination group,n =35) or antitubercular treatment only (single group,n =33).Chi-square and rank sum tests were performed to compare the incidence of liver damages,adjustment or termination of antitubercular treatment,and HBV reactivations between two groups.Results Liver damage was observed in 5 patients (5/35,14.29％) of combination group and in 15 patients (15/33,45.45％) of single group (x2 =7.95,P ＜ 0.05).One patient (1/35,2.86％) in combination group adjusted the therapy,while 13 patients (13/33,39.39％) in single group adjusted or terminated treatment (x2 =13.87,P ＜0.01).HBV reactivation occurred in 2 patients (2/35,5.71％) of combination group,but in 10 patients (10/33,30.30％) of single group (x2 =7.34,P ＜ 0.01).Conclusion Telbivudine can effectively alleviate liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infections.
