声脉冲辐射力成像评价恩替卡韦、复方鳖甲软肝片联合治疗肝纤维化的疗效研究

Therapeutic Efficacy of Combined Administration of Entecavir and Fufang Biejia Ruangan Tablets for Patients with Chronic Hepatitis B-related Liver Fibrosis Evaluated by ARFI Technique

目的:使用声脉冲辐射力成像技术(ARFI),评价在恩替卡韦分散片抗病毒的基础上联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的疗效。方法:对96例慢性乙型肝炎患者经恩替卡韦分散片联合复方鳖甲软肝片治疗前后行声脉冲辐射力成像检查,记录所检测到的VTQ值,并同时检测肝功能、肝纤维化指标等,观察时间节点为24和48周,分析VTQ值、肝功能、肝纤维化指标的变化。计量资料用(x珋±s)表示,采用t检验,P<0.05为差异有统计学意义。结果 96例患者在治疗24周及48周,患者的VTQ值、常规检查的肝功能指标(ALT、AST)和肝纤维化指标(HA、LN、CIV和PCⅢ)均较治疗前明显降低(P<0.05);且治疗48周后的VTQ值、肝纤维化指标也分别显著低于治疗24周后的值(P<0.05),然而,48周后肝功能指标相对24周的值没有统计学意义(P>0.05)。结论与传统肝纤维化指标相比,声脉冲辐射力成像是一种简便可靠的临床检查肝纤维化及评价疗效的技术手段。同时,该临床研究也表明:恩替卡韦分散片联合复方鳖甲软肝片是治疗慢性乙型肝炎肝纤维化的有效组合。

Objective： To evaluate the therapeutic efficacy of combined administration of entecavir and Fufang Biejia Ruangan tablets for the patients with chronic hepatitis B-related liver fibrosis and the diagnostic feasibility of acoustic radiation force impulse imaging（ ARFI） technique for these cases. Methods： 96 patients with chronic hepatitis B-related liver fibrosis were combined administrated by entecavir dispersible tablets and Fufang Biejia Ruangan tablets,the liver function test,liver fibrosis test and ARFI were carried out at 0 day,24 w,and 48 w,respectively,to evaluate the therapeutic efficacy. All data are presented as a mean value with its standard deviation indicated（ ^-x± s）. Statistical analysis was conducted using the Students＇ t-test. Differences were considered to be statistically significant when the p values were less than 0. 05. Results： In all cases,at both 24 w and 48 w,the values of VTQ of ARFI,liver function（ ALT,AST）and liver fibrosis（ HA,LN,CIV,PCⅢ） decreased significantly compared to that before treatment（ P〈0. 05）. Compared with those values in 24 w,the values of VTQ and liver fibrosis at 48 w decreased significantly（ P〈0. 05）,however,the values of liver functions not. Conclulions： Compared with the traditional examination of the values of liver fibrosis in blood samples,ARFI is a feasible technique to diagnose liver fibrosis and evaluate the therapeutic efficacy of drugs.Moreover,this study also shows that it is a good choice to treat chronic hepatitis B-related liver fibrosis by combined administration of entecavir dispersible tablets and Fufang Biejia Ruangan tablets.