核苷类似物联合糖皮质激素治疗高转氨酶慢性乙型肝炎患者的意义

Significance of nucleoside analogues combined with glucocorticoid therapy to CHB patient with high transaminase

目的探讨核苷类似物联合糖皮质激素治疗高转氨酶慢性乙型肝炎患者的意义。方法随机选取本院88例高转氨酶慢性乙型肝炎患者,将其分为两组,对照组43例,给予常规内科治疗;观察组45例,在常规治疗的基础上加用核苷类似物联合糖皮质激素治疗,比较两组患者的治疗疗效及联合治疗的临床意义。结果观察组治疗总有效率高达97.78%,显著高于对照组(74.42%),差异有统计学意义(P<0.05);观察组血清生化指标:谷丙转氨酶(ALT)、总胆红素(TBIL)显著低于对照组,白蛋白(ALB)、凝血酶原时间(PT)显著高于对照组,差异均有统计学意义(P<0.05);观察组ALT复常率、乙肝病毒的脱氧核糖核酸(HBV-DNA)阴转率与乙型肝炎e抗原(HBeAg)血清转换率分别为62.22%、53.33%与13.33%,均显著高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论核苷类似物联合糖皮质激素治疗慢性乙型肝炎的疗效佳,显著改善血清生化指标与肝功能,不良反应与并发症低,是一种有效、安全的治疗方式。

Objective To discuss significance of nucleoside analogues combined with glucocorticoid therapy to CHB patient with high transaminase. Methods 88 CHB patients with high transaminase level were selected and divided into two groups randomly; control group （n=43） were given conventional therapy; observation group （n=45） were treated with conventional therapy plus nucleoside analogues combined with glucocorticoid.Efficacy was compared and clinical significance of combined therapy was analyzed. Results Total effective rate of observation group was significantly higher than that of control group （P〈0.05）. Serum biochemical indexes of ALT and TBIL of observation group were significantly lower than those of control group; ALB and PT of observation group were significantly higher than those of control group （P〈0.05） ;ALT complex constant, HBV-DNA negative conversion and HBeAg serum conversion of observation group were significantly higher than those of control group （P〈0.05） ; complication rate of observation group was significantly lower than control group（P〈0.05）. Conclusions Combined therapy could improve curative effect, which was demonstrated by the serum biochemical indicators, liver function, and complications rate. It is an effective and safe therapy.