富马酸丙酚替诺福韦联合双环醇治疗慢性乙型肝炎合并脂肪肝的疗效

Tenofovir Alafenamide Fumarate Combined with Bicyclol in the Treatment of Chronic Hepatitis B Combined with Fatty Liver Disease

目的探究富马酸丙酚替诺福韦(TAF)联合双环醇治疗慢性乙型肝炎合并脂肪肝的效果。方法选择赣州市南康区第一人民医院2020年4月至2022年8月期间收治的88例慢性乙型肝炎合并脂肪肝患者为研究对象,按照随机数字表法分为对照组和观察组,每组44例。对照组给予TAF治疗,观察组给予TAF联合双环醇片治疗。治疗48周后比较两组治疗效果和相关指标的变化。结果治疗后,两组的血清丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)活性均较治疗前下降;观察组的肝脏脂肪控制衰减指数(CAP)水平较治疗前下降,且观察组的ALT、AST活性和CAP水平均较对照组低,差异有统计学意义(P<0.05);观察组血清乙型肝炎病毒DNA(HBV-DNA)、乙肝e抗原(HBeAg)水平和肝脏硬度值(LSM)均低于对照组,差异有统计学意义(P<0.05)。观察组的不良反应发生率为4.5%,低于对照组的27.3%(P<0.05)。结论采用富马酸丙酚替诺福韦联合双环醇对慢性乙型肝炎合并脂肪肝患者实施治疗,能改善患者肝功能和肝脏脂肪变程度,抑制病毒水平,安全性高。

Objective To investigate the efficacy of tenofovir alafenamide fumarate(TAF)combined with bicyclol in the treatment of chronic hepatitis B combined with fatty liver.Methods Selected 88 patients with chronic hepatitis B combined with fatty liver,admitted to The First People's Hospital of Nankang District between April 2020 and August 2022 as study subjects.They were randomly assigned to either the control group and the observation group,with 44 patients in each group.The control group received TAF therapy,while the observation group were treated with TAF and bicyclol tablets.After 48 weeks of treatment,compared the therapeutic outcomes and changes in relevant indicators between the two groups.Results After 48 weeks of treatment,both groups reduced serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)activities.The hepatic fat control attenuation index(CAP)level in the observation group decreased compared to before treatment,and the ALT,AST activity,and CAP levels in the observation group were lower than those in the control group,with statistical significance(P<0.05);the serum levels of hepatitis B virus DNA(HBV-DNA),hepatitis B e antigen(HBeAg)and liver hardness value(LSM)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 4.5%,lower than the 27.3%in the control group(P<0.05).Conclusion Treatment of patients with chronic hepatitis B combined with fatty liver using tenofovir disoproxil fumarate combined with bicyclol improves liver function and hepatic steatosis,suppresses viral load,and exhibits a high safety profile.