前列地尔联合恩替卡韦治疗乙型肝炎肝硬化失代偿期患者的临床效果

Clinical Effect of Alprostadil Combined with Entecavir on Patients with Decompensated Hepatitis B Cirrhosis

目的探讨前列地尔联合恩替卡韦治疗乙型肝炎肝硬化失代偿期患者的临床效果。方法纳入鹿邑真源医院2018年4月至2020年4月收治的164例乙型肝炎肝硬化失代偿期患者为研究对象。根据治疗方案将患者分为参照组(82例)和观察组(82例)。参照组患者在常规护肝治疗的基础上接受恩替卡韦治疗。观察组患者在常规护肝治疗的基础上接受前列地尔联合恩替卡韦治疗。比较两组患者的治疗总有效率。比较两组治疗前和治疗4周后血清谷丙转氨酶(GPT)、谷草转氨酶(GOT)、白蛋白(Alb)、总胆红素(T-Bil)、层黏连蛋白(LN)、Ⅳ型胶原、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平。结果观察组治疗总有效率(96.34%)较参照组(86.59%)高(P<0.05)。治疗后,观察组GPT、GOT、T-Bil水平低于参照组,Alb水平高于参照组(P<0.05)。治疗后,观察组LN、Ⅳ型胶原、HA、PCⅢ水平低于参照组(P<0.05)。治疗后,观察组TNF-α、hs-CRP、IL-6水平低于参照组(P<0.05)。结论对乙型肝炎肝硬化失代偿期患者采用前列地尔联合恩替卡韦的治疗效果显著,可有效恢复患者的肝功能,改善和控制患者的肝纤维化进展的程度,减轻炎症反应的程度。

Objective To explore the clinical effect of alprostadil combined with entecavir in the treatment of patients with decompensated hepatitis B cirrhosis.Methods A total of 164 patients with decompensated hepatitis B cirrhosis treated in Luyi Zhenyuan Hospital from April 2018 to April 2020 were included as the research objects.According to the treatment plan,the patients were divided into reference group(82 cases)and observation group(82 cases).The patients in reference group were treated with entecavir on the basis of routine liver protection therapy.The patients in observation group were treated with alprostadil combined with entecavir on the basis of routine liver protection therapy.The total effective rate of treatment was compared between the two groups.Serum glutamic-pyruvic transaminase(GPT),glutamic-pyruvic transaminase(GOT),albumin(Alb),total bilirubin(T-Bil),laminin(LN),typeⅣcollagen,hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),tumor necrosis factor-α(TNF-α),hypersensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)were compared between the two groups before and after 4 weeks of treatment.Results The total effective rate of observation group(96.34%)was higher than that(86.59%)of reference group(P<0.05).After treatment,the levels of GPT,GOT and T-Bil in observation group were lower than those in reference group,and the level of Alb was higher than that in reference group(P<0.05).After treatment,the levels of LN,typeⅣcollagen,HA and PCⅢin observation group were lower than those in reference group(P<0.05).After treatment,the levels of TNF-α,hs-CRP and IL-6 in observation group were lower than those in reference group(P<0.05).Conclusion Alprostadil combined with entecavir is effective in the treatment of patients with decompensated hepatitis B cirrhosis,which can effectively restore the liver function,improve and control the progress of liver fibrosis and reduce the degree of inflammatory reaction.