恩替卡韦治疗慢性乙型肝炎对机体炎症反应、肝功能及肝纤维化的影响

Effects of entecavir on inflammatory reaction,liver function and liver fibrosis in chronic hepatitis B patients

目的:观察恩替卡韦治疗慢性乙型肝炎对机体炎症反应、肝功能及肝纤维化的影响。方法:选取我院2015年2月~2016年10月收治的100例慢性乙型肝炎患者,随机分为观察组和对照组,每组各50例。对照组给予还原型谷胱甘肽和复方甘草酸苷等常规护肝治疗;观察组在对照组治疗的基础上加用恩替卡韦分散片治疗。对两组患者治疗前后炎症因子、肝功能及肝纤维化指标进行比较。结果:治疗前,炎症因子水平、肝功能指标水平及肝纤维化指标在两组之间差异不显著(P>0.05)。治疗后,两组炎症因子转化生长因子-β1(TGF-β1)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)水平均低于治疗前(P<0.05),观察组TGF-β1水平(144.94±36.21)μg/L、hs-CRP水平(48.81±10.74)ng/L及TNF-α水平(82.43±22.29)pg/mL均明显低于对照组相应水平,对比差异均有显著性(P<0.05)。治疗后,两组丙氨酸转氨酶(ALT)、天冬氨酸转移酶(AST)水平较治疗前均显著降低(P<0.05),总胆红素(TBiL)水平与治疗前相比差异不显著(P>0.05)。治疗后,观察组ALT水平(35.71±17.81)U/L、AST水平(38.82±14.51)U/L显著低于对照组相应水平(P<0.05),TBiL水平与对照组相比差异不明显(P>0.05)。治疗后,观察组透明质酸酶(HA)(91.71±20.81)μg/mL、Ⅳ胶原(IVC)(140.82±48.51)μg/L、层黏蛋白(LN)水平(73.02±21.06)μg/mL均明显低于对照组(P<0.05)。结论:恩替卡韦联合常规药物治疗能有效改善慢性乙型肝炎患者炎症状态,增强患者肝功能,降低肝纤维化水平。

Objective：To observe the effects of entecavir on the inflammatory reaction,liver function and liver fibrosis in patients with chronic hepatitis B.Method：100 patients with chronic hepatitis B admitted from February 2015 to October2016 in our hospital were randomly divided into observation group（50 cases）and control group（50 cases）.The control group were given oxymatrine,reduced glutathione and compound glycyrrhizin and other conventional liver protection;the observation group received entecavir dispersible tablets based on the treatment of the control group.The changes of inflammatory factors,liver function and liver fibrosis indexes were compared.Results：Liver function indexes and liver fibrosis indexes between the two groups（P〈0.05）.After treatment,the two TGF-β1,hs-CRP and TNF-αlevels significantly lower than those in（P〈0.05）before treatment,After treatment,TGF-β1（144.94±36.21）μg/L,hs-CRP levels（48.81±10.74）ng/L and TNF-αlevels（82.43±22.29）pg/mL were significantly lower in the observation group than in the control group.There was significant difference between the two groups（P〈0.05）.After treatment,both groups ALT,and AST levels were significantly lower than before treatment（P〈0.05）.After treatment,the ALT level（35.71±17.81）U/L and AST level（38.82±14.51）U/L in the observation group were significantly lower than those in the control group（P〈0.05）,while the TBiL levels in the observation group were not significantly different from that in the control group（P〉0.05）.After treatment,the levels of HA（91.71± 20.81）μg/mL and IV-C（140.82±48.51）μg/L and LN（73.02±21.06）μg/mL in the observation group were significantly lower than those in the control group（P〈0.05）.Conclusion：Entecavir combined with conventional drug therapy can effectively improve the inflammatory state of patients with chronic hepatitis B,enhance liver function and reduce liver fibrosis.