恩替卡韦联合乙肝疫苗对慢性乙肝患者治疗的临床研究

Clinical study of entecavir combined with hepatitis B vaccine in the treatment of patients with chronic hepatitis B

目的分析恩替卡韦联合乙型肝炎(乙肝)疫苗对慢性乙肝患者进行治疗的临床效果,以便为临床治疗工作提供有价值的依据。方法 50例慢性乙肝患者作为研究对象,将所有患者随机分为常规治疗组和联合治疗组,每组25例,常规治疗组患者选择恩替卡伟治疗,联合治疗组选择恩替卡韦联合乙肝疫苗治疗,对两组患者的治疗效果进行评价。结果治疗后,联合治疗组乙肝e抗原(HBeAg)血清转换率和HBV DNA下降率分别为68.00%(17/25)、80.00%(20/25),常规治疗组HBeAg血清转换率和HBV DNA下降率分别为36.00%(9/25)、52.00%(13/25),联合治疗组HBeAg血清转换率和HBV DNA下降率均高于常规治疗组,差异具有统计学意义(P<0.05)。治疗后,联合治疗组透明质酸(HA)、层粘蛋白(LN)、Ⅳ型胶原(CⅣ)、Ⅲ型前胶原(PCⅢ)水平分别为(109.5±15.4)、(106.6±13.7)、(100.6±9.3)、(37.4±5.5)μg/L,常规治疗组HA、LN、CⅣ、PCⅢ水平分别为(128.6±12.3)、(130.7±16.6)、(110.5±8.5)、(44.3±4.3)μg/L,联合治疗组HA、LN、CⅣ、PCⅢ水平均优于常规治疗组,差异具有统计学意义(P<0.05)。治疗后,联合治疗组表面抗原滴度和表面抗体滴度分别为(0.3±0.1)ng/ml、(31.5±7.4)IU/ml,常规治疗组表面抗原滴度和表面抗体滴度分别为(0.9±0.2)ng/ml、(26.5±4.0)IU/ml,联合治疗组表面抗原滴度和表面抗体滴度均优于常规治疗组,差异具有统计学意义(P<0.05)。结论在治疗慢性乙肝患者的过程中为患者采用恩替卡韦联合乙肝疫苗进行治疗,能够取得确切的治疗效果,可有效改善患者的相关指标,帮助患者提升血清转换率,促进患者病情的康复,值得推广。

Objective To analyze the clinical effect of entecavir combined with hepatitis B vaccine in the treatment of patients with chronic hepatitis B, so as to provide valuable basis for clinical treatment work. Methods A total of 50 patients with chronic hepatitis B as study subjects were randomly divided into conventional group and combined group, with 25 cases in each group. The conventional group was treated with entecavir, and the combined group was treated with entecavir combined with hepatitis B vaccine. The treatment effect was evaluated in two groups. Results After treatment, the combine group had serum conversion rate of hepatitis B e antigen (HBeAg) and decrease rate of HBV DNA respectively as as 68.00%(17/25) and 80.00%(20/25), which were 36.00%(9/25) and 52.00%(13/25) in conventional group. The combine group had higher serum conversion rate of hepatitis B E antigen (HBeAg) and decrease rate of HBV DNA than conventional group, and the difference was statistically significant (P<0.05). After treatment, the combined group had levels of hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (C Ⅳ), and type Ⅲ procollagen (PC Ⅲ) were respectively as (109.5±15.4),(106.6±13.7),(100.6±9.3) and (37.4±5.5)μg/L, which were (128.6±12.3),(130.7±16.6),(110.5±8.5) and (44.3±4.3)μg/L in conventional group. The combined group had better HA, LN, C Ⅳ, PC Ⅲ level than conventional group, and the difference was statistically significant (P<0.05). After treatment, the combined group had surface antigen titer and surface antibody titer respectively as (0.3±0.1) ng/ml,(31.5±7.4) IU/ml, which were (0.9±0.2) ng/ml and (26.5±4.0) IU/ml in conventional group. The combined group had better surface antigen titer and surface antibody titer than conventional group, and the difference was statistically significant (P<0.05). Conclusion Combination of entecavir and hepatitis B vaccine can achieve definite treatment effect in the treatment of patients with chronic hepatitis B. It can effectively improve the related indicators of patients, help patients improve serum conversion rate, and promote the rehabilitation of patients. It is worth promoting.