中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
1期
60-62
,共3页
欧阳石%刘树人%杨俊%梁志强
歐暘石%劉樹人%楊俊%樑誌彊
구양석%류수인%양준%량지강
肝硬化%乙型肝炎%恩替卡韦%肝复乐%联合治疗
肝硬化%乙型肝炎%恩替卡韋%肝複樂%聯閤治療
간경화%을형간염%은체잡위%간복악%연합치료
Liver cirrhosis%Hepatitis B%Enticavir%Ganfule%Combined therapy
目的 评价恩替卡韦联合肝复乐片治疗乙型肝炎肝硬化的临床疗效.方法 121例活动性乙型肝炎肝硬化患者完全随机分为观察组(58例)和对照组(63例).对照组在护肝、对症等常规治疗基础上口服恩替卡韦0.5 mg/d,观察组在对照组基础上口服肝复乐片3g/次、3次/d,疗程均为48周.均随访24周,随访期间均继续服用恩替卡韦.结果 治疗24周后2组患者肝功能指标均有改善,观察组较对照组更明显[ALT:(50 ±31)U/L比(64-40) U/L,总胆红素:(33±19)μmol/L比(43±24)μmol/L,白蛋白:(34±8)g/L比(33 ±9)g/L,均P＜0.05]；同一时段HBV DNA转阴率观察组与对照组比较差异无统计学意义；2组患者的门静脉宽度及脾脏厚度自48周始均有不同程度缩小,至随访24周末,观察组的门静脉宽度及脾脏厚度缩小较对照组更明显[(1.29±0.29) cm比(1.33±0.29)cm,(4.1 ±0.7)cm比(4.2 ±0.9)cm,P＜0.05]；观察组与对照组患者Child-Pugh评分分别由治疗前(9.8±1.5)分和(9.5±1.1)分降至治疗后(7.2±1.4)分和(7.1±1.6)分,2组治疗后比较差异无统计学意义(P＞0.05).结论 恩替卡韦联合和肝复乐片治疗活动性乙型肝炎肝硬化能持续抑制病毒复制,促进肝功能恢复.
目的 評價恩替卡韋聯閤肝複樂片治療乙型肝炎肝硬化的臨床療效.方法 121例活動性乙型肝炎肝硬化患者完全隨機分為觀察組(58例)和對照組(63例).對照組在護肝、對癥等常規治療基礎上口服恩替卡韋0.5 mg/d,觀察組在對照組基礎上口服肝複樂片3g/次、3次/d,療程均為48週.均隨訪24週,隨訪期間均繼續服用恩替卡韋.結果 治療24週後2組患者肝功能指標均有改善,觀察組較對照組更明顯[ALT:(50 ±31)U/L比(64-40) U/L,總膽紅素:(33±19)μmol/L比(43±24)μmol/L,白蛋白:(34±8)g/L比(33 ±9)g/L,均P＜0.05]；同一時段HBV DNA轉陰率觀察組與對照組比較差異無統計學意義；2組患者的門靜脈寬度及脾髒厚度自48週始均有不同程度縮小,至隨訪24週末,觀察組的門靜脈寬度及脾髒厚度縮小較對照組更明顯[(1.29±0.29) cm比(1.33±0.29)cm,(4.1 ±0.7)cm比(4.2 ±0.9)cm,P＜0.05]；觀察組與對照組患者Child-Pugh評分分彆由治療前(9.8±1.5)分和(9.5±1.1)分降至治療後(7.2±1.4)分和(7.1±1.6)分,2組治療後比較差異無統計學意義(P＞0.05).結論 恩替卡韋聯閤和肝複樂片治療活動性乙型肝炎肝硬化能持續抑製病毒複製,促進肝功能恢複.
목적 평개은체잡위연합간복악편치료을형간염간경화적림상료효.방법 121례활동성을형간염간경화환자완전수궤분위관찰조(58례)화대조조(63례).대조조재호간、대증등상규치료기출상구복은체잡위0.5 mg/d,관찰조재대조조기출상구복간복악편3g/차、3차/d,료정균위48주.균수방24주,수방기간균계속복용은체잡위.결과 치료24주후2조환자간공능지표균유개선,관찰조교대조조경명현[ALT:(50 ±31)U/L비(64-40) U/L,총담홍소:(33±19)μmol/L비(43±24)μmol/L,백단백:(34±8)g/L비(33 ±9)g/L,균P＜0.05]；동일시단HBV DNA전음솔관찰조여대조조비교차이무통계학의의；2조환자적문정맥관도급비장후도자48주시균유불동정도축소,지수방24주말,관찰조적문정맥관도급비장후도축소교대조조경명현[(1.29±0.29) cm비(1.33±0.29)cm,(4.1 ±0.7)cm비(4.2 ±0.9)cm,P＜0.05]；관찰조여대조조환자Child-Pugh평분분별유치료전(9.8±1.5)분화(9.5±1.1)분강지치료후(7.2±1.4)분화(7.1±1.6)분,2조치료후비교차이무통계학의의(P＞0.05).결론 은체잡위연합화간복악편치료활동성을형간염간경화능지속억제병독복제,촉진간공능회복.
Objective To observe effect of combination of ganfule and enticavir on liver cirrhosis with chronic hepatitis B.Methods All 121 cases with liver cirrhosis with hepatitis B were randomly divided into two groups:control group (63 cases) and treatment group (58 cases).Both groups were administered with routine therapy and enticavir (0.5 mg,qd) ; the treatment group had extra ganfule (6 tablets,tid,for 48 weeks).Results After treatment,the liver function of patients in the two groups were both ameliorated obviously,and the liver function of patients in the treatment group was more remarkably ameliorated than control group(P ＜ 0.05).The level of HBV DNA was decreased in both groups.The diameter of portal vein and the thickness of spleen of patients were reduced significantly in both groups after 48 weeks.After 24 weeks the diameter of portal vein and the thickness of spleen in treatment group were reduced more significantly than those in control group.The Child-Pugh score of patients in observation group and control group decreased from (9.8 ± 1.5) scores and (9.5 ± 1.1) scores to (7.2 ± 1.4) scores and (7.1 ± 1.6) scores after treatment,respectively.Conclusions The combined therapy of ganfule and enticavir on liver cirrhosis with chronic hepatitis B can inhibit HBV replication,ameliorate liver function and decrease Child-Pugh score.
