甘草酸二铵联合恩替卡韦对乙肝合并肝硬化患者肝纤维化指标及肝功能的影响

Effects of Diammonium Glycyrrhizinate Combined with Entecavir on Liver Fibrosis Indexes and Liver Function in Patients with Hepatitis B and Cirrhosis

目的:探讨甘草酸二铵联合恩替卡韦治疗慢性乙型肝炎(CHB)合并肝硬化的临床效果和对肝纤维化的影响。方法:选取2018年2月—2020年2月广东医科大学附属第二医院收治的86例CHB合并肝硬化患者作为研究对象,按随机数表法分为对照组和观察组,每组各43例。对照组予以恩替卡韦治疗,观察组加用甘草酸二铵治疗。比较两组治疗效果。结果:观察组总有效率高于对照组,差异有统计学意义(χ^(2)=4.074,P<0.05);观察组治疗后层黏连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)水平、天冬氨酸氨基转移酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)水平、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平低于对照组,差异有统计学意义(t=4.402、4.859、5.530、7.916、9.181、8.322、8.254、7.039,P<0.05);两组均无严重不良反应发生,差异无统计学意义(χ^(2)=0.000,P>0.05)。结论:甘草酸二铵联合恩替卡韦治疗可阻止CHB合并肝硬化患者肝纤维化进程,减轻肝脏内炎症反应,促进肝功能恢复,安全可靠。

Objective:To investigate the clinical effect of diammonium glycyrrhizinate combined with entecavir in the treatment of chronic hepatitis B(CHB)complicated with liver cirrhosis and its effect on liver fibrosis.Methods:A total of 86 patients with CHB complicated with liver cirrhosis who were admitted to the hospital from February 2018 to February 2020 were selected and di⁃vided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was treated with entecavir,and the observation group was additionally treated with diammonium glycyrrhizinate.The clinical efficacy of the two groups was compared.Results:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=4.074,P<0.05).After treatment,the levels of laminin(LN),hyaluronic acid(HA),type IV collagen(IV-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total biliru⁃bin in the observation group after treatment The levels of TBIL,interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were lower than those in the control group,and the differences were statistically significant(t=4.402,4.859,5.530,7.916,9.181,8.322,8.254,7.039,P<0.05).There were no serious adverse reactions in the two groups,and the difference was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion:Diammonium glycyrrhizinate combined with entecavir therapy can pre⁃vent the process of liver fibrosis in patients with CHB complicated with liver cirrhosis,reduce the inflammatory response in the liver,and promote the recovery of liver function,which is safe and reliable.