复方甘草酸苷联合恩替卡韦治疗HBV相关ACLF疗效分析

Efficacy of compound glycyrrhizin combined with entecavir in the treatment of HBV related ACLF

目的 探讨复方甘草酸苷联合恩替卡韦治疗乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者的疗效。方法 选取HBV相关ACLF患者73例,根据用药不同将其分为观察组(恩替卡韦口服+复方甘草酸苷注射)和对照组(恩替卡韦口服)。比较两组治疗前后HBsAg、HBeAg和HBV DNA载量、肝功能指标[白蛋白(ALB)、总胆红素(TBIL)、谷草转氨酶(AST)和谷丙转氨酶(ALT)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)水平、凝血酶原活动度(PTA)和国际标准化比值(INR)],以及患者生存状况。结果 与治疗前比较,两组治疗后HBsAg、HBeAg和HBV DNA载量降低(P<0.05)。与治疗前比较,两组治疗后ALB、FIB、PTA升高,TBIL、AST、ALT、PT、APTT、TT、INR降低,且观察组较对照组改善更为显著(P<0.05)。观察组患者生存时间长于对照组(P<0.05)。结论 复方甘草酸苷联合恩替卡韦治疗HBV相关ACLF具有显著疗效,可延长患者生存期。

Aim To investigate the efficacy of compound glycyrrhizin combined with entecavir in the treatment of chronic and acute liver failure(ACLF) associated with hepatitis B virus(HBV). Methods 73 patients with HBV related ACLF were selected and divided into the observation group(entecavir oral+compound glycyrrhizin injection) and the control group(entecavir oral) according to different medication. HBsAg, HBeAg and HBV DNA load, liver function indexes [albumin(ALB), total bilirubin(TBIL), glutamic oxaloaminase(AST) and glutamic pyruvic transaminase(ALT)], coagulation function indexes [prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), prothrombin activity(PTA) and international normalized ratio(INR)], the survival status of the patientswere compared between the two groups before and after treatment. Results Compared with that before treatment, HBsAg, HBeAg and HBV DNA load in the two groups were decreased after treatment(P<0.05). Compared with that before treatment, ALB, FIB and PTA were increased, TBIL, AST, alt, Pt, APTT, TT and INR were decreased in the two groups after treatment, and the improvement in the observation group was more significant than the control group(P<0.05). The survival time of the observation group was longer than that ofthe control group(P<0.05). Conclusion Compound glycyrrhizin for injection combined with entecavir in the treatment of HBV related ACLF has a significant effect and can prolong the survival of patients.