恩替卡韦对代偿期乙型病毒性肝炎肝硬化患者血清甲状腺激素的影响

Effect of Entecavir on the Serum Thyroid Hormone of Patients with Hepatitis B Virus and Cirrhosis During Decompensation

目的探讨恩替卡韦对代偿期乙型病毒性肝炎肝硬化患者血清甲状腺激素的影响。方法选取2015年10月—2017年9月该科室诊治的50例代偿期乙型病毒性肝炎肝硬化患者作为试验组,随机调取同期体检健康患者50例作为对照组,试验组应用恩替卡韦加以诊治,1次/d,0.5 mg/次,治疗周期为6个月。除此之外,给予患者心理治疗、健康宣教、保肝治疗等措施。检测2组治疗前后血清甲状腺激素指标;检测试验组治疗前后HBV-DNA未转阴或已转阴患者血清甲状腺激素以及肝功能指标。结果 2组相较而言,治疗前试验组TSH水平较高(P<0.05),T3、FT3、T4、FT4水平较低(P<0.05)。转阴患者治疗后的TSH、T3、FT3、T4、FT4分别为(2.59±1.20)u IU/mL、(1.22±0.48)ng/mL、(3.16±0.81)Pg/mL、(8.21±2.43)μg/dL、(1.33±0.88)ng/mL,较治疗前而言,试验组未转阴患者TSH、T3、FT3、T4、FT4水平无显著改善,转阴患者各项变化明显。治疗后转阴患者的PT(13.12±2.33)s、AST(62.56±14.76)U/L、ALT(59.21±13.52)U/L、TBIL(19.31±7.88)μmol/L、ALB(37.21±2.98)g/L,较治疗前而言,试验组治疗后各项肝功能水差异有统计学意义(P<0.05);较未转阴患者而言,转阴患者PT、AST、ALB水平均大幅改善(P<0.05)。结论在代偿期乙型病毒性肝炎肝硬化治疗中,采取恩替卡韦药物,能够有效改善患者血清甲状腺激素水平,达到HBV-DNA转阴目的,同时提升患者肝功能水平,促使患者肝功能指标保持稳定状态,临床效果较为显著,因此,可以大力实践与推广。

Objective To study the effect of entecavir on the serum thyroid hormone of patients with hepatitis B virus and cirrhosis during decompensation. Methods 50 cases of patients with hepatitis B virus and cirrhosis during decompensation diagnosed in our hospital from October 2015 to September 2017 were selected as the test group, and 50 cases of healthy physical examination patients at the same period were randomly extracted as the control group, and the test group were treated with entecavir, once per day, 0.5 mg each time, and the treatment cycle was 6 months, besides, the patients were for mental therapy, health education and liver-conserving therapy, and the serum thyroid hormone indexes before and after treatment were tested, and the serum thyroid hormone and liver function indexes of HBV-DNA patients who were not converted to negative and HBV-DNA patients who had already converted to negative before and after treatment in the test group were tested. Results The TSH level in the test group before treatment was higher（P〈0.05）,T3, FT3, T4, FT4 levels were lower（P〈0.05）, and the TSH, T3, FT3, T4, FT4 levels of patients converted to negative after treatment were respectively（2.59±1.20）u IU/mL,（1.22±0.48）ng/mL,（3.16±0.81）Pg/mL,（8.21±2.43）μg/d L,（1.33±0.88）ng/mL, and the TSH, T3, FT3, T4, FT4 levels of patients who were not converted to negative in the test group were not obviously improved, and various changes of patients converted to negative were obvious, after treatment, the PT（13.12±2.33）s, AST（62.56±14.76）U/L, ALT（59.21 ±13.52）U/L, TBIL（19.31 ±7.88）μmol/L, ALB（37.21 ±2.98）g/L in the test group were obviously improved compared with those before treatment thedifference was statistically significant（P〈0.05）,and the PT, AST, ALB levels of patients converted to negative were greatly improved（P〈0.05）. Conclusion The entecavir in treatment of patients with hepatitis B virus and cirrhosis during decompensation can effectively improve the serum thyroid hormone level of patients and make the HBV-DNA converted to negative, and improve the liver function level and promote the liver function indexes steady, and the clinical effect is obvious, therefore, it can be greatly promoted and applied.