恩替卡韦治疗慢性乙型病毒性肝炎的效果观察

Observation on effect of entecavir on patients with chronic hepatitis B

目的探讨恩替卡韦治疗慢性乙型病毒性肝炎(乙肝,CHB)的临床效果及对患者肝功能、乙肝病毒载量(HBV-DNA)和肝纤维化的影响。方法60例乙肝患者,以随机数字表法分为对照组和观察组,各30例。对照组实施常规治疗,观察组实施恩替卡韦治疗。比较两组治疗效果、不良反应发生情况及治疗前后肝功能指标[白蛋白(ALB)、总胆红素(TBiL)和谷丙转氨酶(ALT)]、HBV-DNA水平、肝纤维化指标[Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)和层粘连蛋白(LN)]。结果治疗后,观察组ALB(38.26±2.63)g/L、TBiL(31.50±10.59)μmol/L和ALT(42.51±10.07)U/L均优于对照组的(32.24±3.07)g/L、(47.43±12.65)μmol/L和(85.68±26.67)U/L,差异具有统计学意义(P<0.05)。观察组治疗总有效率93.33%高于对照组的73.33%,差异具有统计学意义(P<0.05)。治疗后,观察组HBV-DNA水平为(2.59±0.23)×10^(3)copies/ml,低于对照组的(3.50±0.29)×10^(3)copies/ml,差异具有统计学意义(P<0.05)。治疗后,观察组LN(161.20±18.93)ng/ml、Ⅳ-C(147.26±44.23)ng/ml和HA(86.67±25.12)mg/L均低于对照组(198.92±27.51)ng/ml、(197.58±52.13)ng/ml和(125.27±31.43)mg/L,差异具有统计学意义(P<0.05)。观察组不良反应发生率10.00%与对照组的16.67%比较,差异无统计学意义(P>0.05)。结论恩替卡韦在乙肝临床治疗中具有较高的应用价值,不仅能够改善肝功能、肝纤维化,同时可促进整体治疗效果的提高,有效控制HBV-DNA,此外,该药物具有安全性高等特点,值得临床进一步采纳与推广。

Objective To discuss the clinical effect of entecavir on patients with chronic hepatitis B(CHB),and its influence on liver function,hepatitis B virus deoxyribonucleic acid(HBV-DNA)and liver fibrosis of patients.Methods A total of 60 patients with chronic hepatitis B were divided into control group and observation group according to random numerical table,with 30 cases in each group.The control group was treated with conventional therapy,and the observation group was treated with entecavir.Both groups were compared in terms of therapeutic effect,occurrence of adverse reactions,liver function indexes[albumin(ALB),total bilirubin(TBiL)and alanine aminotransferase(ALT)],HBV-DNA level,liver fibrosis indexes[typeⅣcollagen(Ⅳ-C),hyaluronidase(HA)and laminin(LN)]before and after treatment.Results After treatment,the levels of ALB,TBiL and ALT in the observation group were(38.26±2.63)g/L,(31.50±10.59)μmol/L and(42.51±10.07)U/L,which were better than(32.24±3.07)g/L,(47.43±12.65)μmol/L and(85.68±26.67)U/L in the control group,and the differences were statistically significant(P<0.05).The total effective rate 93.33%of the observation group was higher than 73.33%of the control group,and the differences were statistically significant(P<0.05).After treatment,the level of HBV-DNA in the observation group was(2.59±0.23)×10^(3) copies/ml,which was lower than(3.50±0.29)×10^(3) copies/ml in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of LN,Ⅳ-C and HA in the observation group were(161.20±18.93)ng/ml,(147.26±44.23)ng/ml and(86.67±25.12)mg/L,which were lower than(198.92±27.51)ng/ml,(197.58±52.13)ng/ml and(125.27±31.43)mg/L in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 10.00%,and the difference was not statistically significant compared with 16.67%in the control group(P>0.05).Conclusion Entecavir has high application value in the clinical treatment of hepatitis B.It can not only improve liver function and liver fibrosis,but also promote the improvement of the overall treatment effect and effectively control HBV-DNA.In addition,the drug has the characteristics of high safety and is worthy of further clinical adoption and promotion.