分析不同核苷(酸)类似物初始治疗乙型肝炎肝硬化的临床效果

Analysis of the Clinical Effect of Different Nucleoside(Acid)Analogs in the Initial Treatment of Hepatitis B Cirrhosis

目的分析乙型肝炎肝硬化初始治疗时选择不同核苷(酸)类似物治疗方案的临床效果差异。方法本次研究选择2020年6月—2021年6月南京市第二医院收治的药物治疗的40例乙型肝炎肝硬化患者,随机抽签法进行分组,各20例。对照组单独使用恩替卡韦进行治疗,观察组则选择富马酸丙酚替诺福韦进行治疗,对比不同用药方案临床效果差异。结果治疗前,两组患者3项肝功能生化指标组间比较差异无统计学意义(P>0.05),治疗后两组各项指标均值组间对比差异无统计学意义(P>0.05);观察组ALT复常率及HBV-DNA转阴率分别为90.00%、80.00%均高于对照组的80.00%、75.00%,但组间差异无统计学意义(χ^(2)=0.196、0.000,P>0.05),观察组耐药性5.00%低于对照组的35.00%,差异有统计学意义(χ^(2)=3.906,P=0.048)。结论乙型肝炎肝硬化初始选择富马酸丙酚替诺福韦进行治疗,总体治疗效果显著,可促进患者肝功能改善,进而能够抑制疾病进展,提升治疗效果及安全性,具有较高应用价值值得借鉴。

Objective To analyze the clinical effect of different nucleoside(acid)analogs in the initial treatment of hepatitis B cirrhosis.Methods This study selected 40 patients with hepatitis B cirrhosis who were treated with drugs in Nanjing Second Hospital from June 2020 to June 2021.Random lottery grouping,20 cases each.The control group was treated with entecavir alone,while the observation group was treated with propofol tenofovir fumarate.The clinical effects of different medication regimens were compared.Results Before treatment,there was no significant difference in the three biochemical indexes of liver function between the two groups(P>0.05).After treatment,there was no statistically significant difference in the mean value of each index between the two groups(P>0.05).The ALT normalization rate and HBV-DNA negative conversion rate in the observation group were 90.00% and 80.00% respectively,which were higher than 80.00% and 75.00% in the control group,but the difference was no statistically significant between the two groups(χ^(2)=0.196,0.000,P>0.05).The drug resistance in the observation group was 5.00%lower than that in the control group 35.00%,and the difference was statistically significant(χ^(2)=3.906,P=0.048).Conclusion The initial treatment of hepatitis B cirrhosis with tenofovir fumarate and alafenamide has a significant overall therapeutic effect,which can improve the liver function of patients,thereby inhibiting the progression of the disease,improving the therapeutic effect and safety,which has high application value and is worthy of reference.