恩替卡韦联合异甘草酸镁治疗慢性乙肝患者临床观察

Pathological changes of liver tissue in chronic hepatitis B patients treated with combination therapy of entecavir and magnesium isoglycyrrhizinate

目的观察恩替卡韦联合异甘草酸镁治疗慢性乙型肝炎患者肝组织病理学的临床变化。方法自2010年4月-2013年8月，收集慢性乙型病毒性肝炎患者70例，随机分为治疗组及对照组各35例，治疗组口服恩替卡韦0．5mg／d、1次／d，同时用异甘草酸镁注射液150mg静脉滴注，10r／d；对照组口服恩替卡韦0．5mg／d、1次/d，疗程为12周，记录两组治疗前后肝组织炎症活动度、肝纤维化程度及血清肝纤维化指标水平，并对两组治疗前后的数据进行统计学分析。结果治疗结束后，两组肝组织炎症活动度（U=433）、肝纤维化程度（U=426．5）相比较差异均有统计学意义（P〈0．05）；两组血清肝纤维化指标：血清透明质酸（t=10．7）、Ⅲ型前胶原（t=-8．48）、Ⅳ型胶原（t=6．7）、层粘连蛋白（t=5．3）相比较差异均有显著统计学意义（P〈0．01）。结论恩替卡韦联合异甘草酸镁治疗慢性乙型肝炎，可明显减轻肝组织炎症活动度及肝纤维化程度，降低血清肝纤维化指标，优于单用恩替卡韦，值得临床推广。

Objective To observe the pathological changes of liver tissue in chronic hepatitis B patients after combination therapy with entecavir and magnesium isoglycyrrhizinate. Methods Totally 70 chronic hepatitis B patients were enroUed from April 2010 to August 2013 and randomly divided into experimental group and control group （35 cases in each group）. Patients in experimental group took entecavir 0.5 mg/d qd orally and magnesium isoglycyrrhizinate 150 mg qd intravenously. The patients in control group only took entecavir orally. Before and 12 weeks after treatment, the degree of liver tissue inflammation, fibrosis and serum marker of liver fibrosis were observed and statistically analyzed. Results After treatment, there were significant differences （P〈0.05） between the two groups in terms of liver tissue inflammation （U=433） and fibrosis （U=426.5）. With regard to the serum marker of liver fibrosis, such as hyaluronic acid （t=10.7）, type Ⅲ procoUagen（t= 8.48）, type IV collagen（t=-6.7） and laminin（t=-5.3）, there were significant differences between the two groups,too （P〈0.01）. Corlclusion Compared with single drug therapy of entecavir, entecavir combined with magnesium isoglyeyrrhizinate significantly reduced the degree of liver tissue inflammation, fibrosis and serum marker of liver fibrosis in chronic hepatitis B patients. The combination therapy is worthy for recommendation in clinical use.