恩替卡韦对肺结核伴乙肝病毒感染患者肝功能的影响

Effect of entecavir on liver function of pulmonary tuberculosis patients infected with hepatitis B virus

目的探讨恩替卡韦对肺结核伴乙型肝炎(乙肝)病毒(HBV)感染患者肝功能的影响。方法90例肺结核伴HBV感染患者,采用随机数字表法分为对照组(47例)和观察组(43例)。对照组采用传统抗结核药物+抗HBV治疗,观察组在对照组基础上给予恩替卡韦治疗。比较两组患者治疗效果、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及总胆红素(TBIL)]及肝损伤发生情况、发生时间。结果观察组患者治疗总有效率为95.35%,高于对照组患者的80.85%,差异具有统计学意义(P<0.05)。观察组肝损伤发生率4.65%低于对照组的19.15%,发生时间(48.73±8.10)d晚于对照组的(27.51±5.43)d,差异具有统计学意义(χ^(2)/t=4.399、4.690,P<0.05)。治疗后,两组AST、ALT、TBIL水平均较本组治疗前降低,且观察组降低幅度大于对照组,差异具有统计学意义(P<0.05)。结论针对肺结核伴HBV感染患者,采用恩替卡韦治疗效果好,能减少肝损伤发生,延缓肝损伤出现时间,加速肝功能恢复。

Objective To discuss the effect of entecavir on liver function of pulmonary tuberculosis patients infected with hepatitis B virus(HBV).Methods A total of 90 cases of pulmonary tuberculosis patients infected with HBV were divided into control group(47 cases)and observation group(43 cases)according to random numerical table.The control group was treated with traditional anti-combination drugs and anti-HBV,and the observation group was treated with entecavir on the basis of the control group.The therapeutic effect,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)],occurrence of liver injury and occurrence time of liver injury were compared between the two groups.Results The total effective rate in the observation group was 95.35%,which was higher than 80.85%in the control group,and the difference was statistically significant(P<0.05).The incidence of liver injury 4.65%in the observation group was lower than 19.15%in the control group,and the occurrence time(48.73±8.10)d was later than(27.51±5.43)d in the control group.All the difference was statistically significant(χ^(2)/t=4.399,4.690;P<0.05).After treatment,the levels of AST,ALT,and TBIL in the two groups were lower than those before treatment,and the reduction in the observation group was greater than that in the control group.All the difference was statistically significant(P<0.05).Conclusion Entecavir has good effect on pulmonary tuberculosis patients infected with HBV,and it can reduce the occurrence of liver injury,delay the occurrence time of liver injury,and accelerate the recovery of liver function.