硫普罗宁联合恩替卡韦对慢性乙型肝炎患者血清病毒学指标及肝纤维化的影响

The effect of tiopronin combined with entecavir on serum virological indicators and liver fibrosis in patients with chronic hepatitis B

目的 探讨慢性乙型肝炎(CHB)患者采用硫普罗宁与恩替卡韦联合治疗对血清病毒学指标及肝纤维化的影响.方法 按随机数字表法将2020年1月-2023年1月于江西省石城县人民医院治疗的86例CHB患者分为两组,每组各43例.对照组采用恩替卡韦治疗,观察组采用恩替卡韦与硫普罗宁联合治疗.比较两组临床疗效、血清病毒学指标、肝纤维化及不良反应.结果 两组治疗总有效率、治疗后的乙肝表面抗原(HBsAg)及乙肝病毒脱氧核糖核酸(HBV-DNA)水平比较,无统计学差异(P>0.05);治疗后两组HBsAg、HBV-DNA及透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)水平均低于治疗前,且观察组HA、LN、PC-Ⅲ、Ⅳ-C水平低于对照组,有统计学差异(P<0.05);两组不良反应发生率比较,无统计学差异(P>0.05).结论 CHB患者采用硫普罗宁与恩替卡韦联合治疗在降低HA、LN、PC-Ⅲ及Ⅳ-C水平方面更具优势,可防止肝纤维化,且并未增加明显不良反应,但在降低HBsAg及HBV-DNA水平方面与单独服用恩替卡韦治疗无差异.

Objective To investigate the effects of combined treatment with tiopronin and entecavir on serum virological indicators and liver fibrosis in patients with chronic hepatitis B(CHB).Method 86 CHB patients who were treated in our hospital from January 2020 to January 2023 were divided into two groups using a random number table method,with 43 patients in each group.The control group was treated with entecavir,while the observation group was treated with a combination of entecavir and tiopronin.Compare the clinical efficacy,serum virological indicators,liver fibrosis,and adverse reactions between the two groups.Results There was no significant difference between the two groups in the total effective rate and the levels of hepatitis B surface antigen(HBsAg)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)after treatment(P>0.05);after treatment,the levels of HBsAg,HBV-DNA,hyaluronidase(HA),laminin(LN),type Ⅲ procollagen(PC-Ⅲ),and type Ⅳ collagen(Ⅳ-C)in both groups were lower than before treatment,and the levels of HA,LN,PC-Ⅲ,and Ⅳ-C in the observation group were lower than those in the control group,with statistical differences(P<0.05);there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination treatment of tiopronin and entecavir is more advantageous in reducing HA,LN,PC-Ⅲ,and Ⅳ-C levels in CHB patients,preventing liver fibrosis without increasing significant adverse reactions.However,there is no difference in reducing HBsAg and HBV-DNA levels compared to entecavir alone treatment.