前列地尔联合阿德福韦酯治疗乙型肝炎肝硬化的效果及对患者肝功能的影响

Effect of alprostadil combined with adefovir dipivoxil in the treatment of hepatitis B cirrhosis and its influence on liver function

目的 观察前列地尔联合阿德福韦酯治疗乙型肝炎肝硬化的效果及对患者肝功能的影响。方法 选择2019年11月至2020年11月于本院接受治疗的86例乙型肝炎肝硬化患者为研究对象,将其随机分为对照组和观察组,每组43例。对照组采用阿德福韦酯治疗,观察组采用前列地尔联合阿德福韦酯治疗。比较两组的血清病毒学指标及其转阴率、血清炎性因子水平、肝功能指标及肝纤维指标。结果 治疗后,两组的HBeAg、HBV DNA水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗24、48周,观察组的HbeAg、HBV DNA转阴率均高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的TNF-α水平低于治疗前,IL-10水平高于治疗前,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的TBIL、AST、ALT水平较治疗前显著降低,ALB水平较治疗前显著升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的LN、HA、PCⅢ水平均较治疗前显著降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论 前列地尔联合阿德福韦酯治疗乙型肝炎肝硬化的效果显著,可一定程度上控制肝硬化病情的进展,有效缓解炎症反应,改善肝功能。

Objective To observe the effect of alprostadil combined with adefovir dipivoxil in the treatment of hepatitis B cirrhosis and its influence on liver function.Methods Eighty-six patients with hepatitis B cirrhosis treated in our hospital from November 2019 to November 2020 were selected as the research objects and randomly divided into control group and observation group,with 43 cases in each group.The control group was treated with adefovir dipivoxil,and the observation group was treated with alprostadil combined with adefovir dipivoxil.The serum virological indexes and their negative conversion rates,the levels of serum inflammatory factors,liver function indexes and liver fiber indexes were compared between the two groups.Results After treatment,the levels of HBeAg and HBV DNA in the two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P <0.05).After 24 and 48 weeks of treatment,the negative conversion rates of HBeAg and HBV DNA in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the TNF-α level in the two groups was lower than that before treatment,the IL-10 level was higher than that before treatment,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of TBIL,AST and ALT in the two groups were significantly lower than those before treatment,the level of ALB was significantly higher than that before treatment,those in the observation group were better than the control group,and the differences were statistically significant(P <0.05).After treatment,the levels of LN,HA and PCⅢ in the two groups were significantly lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P <0.05).Conclusion Alprostadil combined with adefovir dipivoxil is effective in the treatment of hepatitis B cirrhosis,which can control the progress of liver cirrhosis to a certain extent,effectively alleviate inflammatory reaction and improve liver function.