异烟肼联合恩替卡韦对HBV感染合并肺结核患者血清纤维化指标和免疫功能的影响

Effect of isoniazid combined with entecavir on serum fibrosis index and immune function in patients with hepatitis B virus infection and pulmonary tuberculosis

目的:观察异烟肼联合恩替卡韦对HBV感染合并肺结核患者的治疗效果,并探讨对其血清纤维化指标和免疫功能的影响。方法:以2021年6月至2021年12月在我院就诊的80例HBV感染合并肺结核患者为研究对象,随机分为对照组和研究组,每组40例;两组患者均进行常规抗结核、保肝治疗,对照组患者使用异烟肼治疗,研究组患者使用异烟肼^(+)恩替卡韦联合治疗。观察两组患者治疗前后血清纤维化指标、免疫功能、肝功能、肾功能、乙型肝炎病毒e抗原(HBeAg)阴转率、HBV DNA载量、不良反应及临床疗效。结果:两组患者治疗后Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、CD8^(+)、CD4^(+)/CD8^(+)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)低于治疗前,CD4^(+)、尿素氮(BUN)、血肌酐(SCr)、血尿酸(UA)高于治疗前,且研究组PCⅢ、Ⅳ-C、HA、CD8^(+)、CD4^(+)/CD8^(+)、ALT、AST、TBil、BUN、SCr、UA低于对照组,CD4^(+)、高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后HBV DNA载量、HBeAg低于治疗前,HBeAg阴转率高于治疗前,且研究组HBV DNA载量、HBeAg低于对照组,HBeAg阴转率高于对照组,差异具有统计学意义(P<0.05)。研究组患者治疗后总有效率明显高于对照组,差异具有统计学意义(P<0.05)。结论:异烟肼联合恩替卡韦治疗HBV感染合并肺结核患者,可改善患者血清纤维化指标、免疫功能,改善肝肾功能,效果较好。

Objective:To study the therapeutic effect of isoniazid combined with Entecavir on patients with hepatitis B virus infection and pulmonary tuberculosis,and to explore the effect of its serum fibrosis indicators and immune function.Methods:Include 80 patients with hepatitis B virus infection and pulmonary tuberculosis in our hospital from June 2021 to December 2021 as the research objects.Randomly divide them into the control group and the study group.There are 40 patients in each group,and both groups are divided into two groups.Routine anti-tuberculosis and liver-protecting treatments were performed.Patients in the control group were treated with isoniazid,and patients in the study group were treated with isoniazid^(+)entecavir.The serum fibrosis indicators,immune function,liver function,kidney function,hepatitis B virus gene(HBV DNA)load,and hepatitis B surface antigen(HBeAg)negative conversion rate were compared between the two groups before and after treatment,and the treatment effects and adverse reactions of the two groups were counted.Results:After treatment,the two groups of patients were treated with typeⅢprocollagen(procollagen typeⅢ,PCⅢ),typeⅣcollagen(Collage TypeⅣ,Ⅳ-C),hyaluronic acid(HA),CD8^(+),CD4^(+)/CD8^(+),and alanine aminotransferase(Alanine).aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(total bilirubin,TBil)lower than before treatment,CD4^(+),blood urea nitrogen(BUN),serum creatinine(sCr),Blood uric acid(UA)was higher than before treatment,and PCⅢ,Ⅳ-C,HA,CD8^(+),CD4^(+)/CD8^(+),ALT,AST,TBil in the study group were lower than those in the control group,and CD4^(+),BUN,SCr,UA were higher In the control group,there was a statistical difference(P<0.05).After treatment,the HBV DNA load and HBeAg of the two groups were lower than before treatment,and the HBeAg negative conversion rate was higher than before treatment.The HBV DNA load and HBeAg of the study group were lower than the control group,and the HBeAg negative conversion rate was higher than that of the control group.There is a statistical difference(P<0.05).The total effective rate after treatment in the study group was significantly higher than that in the control group,with statistical differences(P<0.05).Conclusion:Isoniazid combined with Entecavir for the treatment of patients with hepatitis B virus infection and pulmonary tuberculosis can improve serum fibrosis indicators,immune function,and liver and kidney functions with better results.