核苷类似物对肺结核合并HBV携带者的疗效观察

Efficacy of Nucleoside Analogues of Tuberculosis and HBV Carriers

目的观察肺结核合并慢性HBV携带者,抗结核治疗过程中核苷类似物抗乙肝病毒治疗对患者肝功能的影响及临床意义。方法肺结核并慢性HBV携带者126例,随机分为两组,抗病毒治疗组63例(核苷类似物+2HREZ/4HR+护肝),对照组63例(2HREZ/4HR+护肝)。比较分析两组患者的肝功能、HBV DNA及预后情况。结果抗病毒治疗组能明显减轻肝功能损害,降低停药率,与对照组比较差异统计学意义(P<0.05),治疗结束时对照组HBV DNA水平较治疗组高(P<0.05)。随访观察,抗病毒治疗组预后好于对照组。结论肺结核合并慢性HBV携带者化疗中应用核苷类似物联合抗结核药物治疗安全有效,可减少肝损害的发生率,降低停药率,提高肺结核患者的治愈率。肺结核合并慢性HBV携带者,建议化疗中常规联用核苷类似物抗HBV治疗。

Objective To observe the tuberculosis complicated with chronic HBV carriers, during antituberculous therapy of nucleoside analogues against hepatitis B virus therapy on liver function of the patients and the effect of Clinical significance. Methods 126 cases of tuberculosis and chronic HBV carriers, were divided into two groups,63 cases in the treatment group （nu- cleoside analogues ＋ 2HREZ/4HR ＋ Liver medicine）, 63 cases in the control group （ 2HREZ/4HR ＋ Liver medicine）. The pa- tient＇ s liver function, HBV DNA and prognosis were observed and analyzed. Results Antiviral treatment group can significantly reduce the damage of liver function, and the discontinuation rate, compared with the control group, there were significant differ- ences. At the end of treatment, HBV DNA levels in treatment group were high. Follow up observation of antiviral therapy, progno-sis was better than that of the control group group. Conclusion Tuberculosis complicated with chronic HBV carriers application in chemotherapy of nucleoside analogues combined antituberculous drug therapy was safe and effective, can reduce the incidence of liver damage rate, reduce the discontinuation rate, improve the cure rate of pulmonary tuberculosis patients. To tuberculosis complicated with chronic HBV carriers,it was suggested that chemotherapy combined with conventional nucleoside analogue treat-ment against HBV.