摘要
目的:观察熊去氧胆酸联合恩替卡韦治疗慢性重型肝炎伴胆汁淤积患者的疗效。方法:选取70例慢性重型肝炎伴胆汁淤积患者,采用回顾性研究方法,将患者随机分为2组。治疗组给予熊去氧胆酸联合恩替卡韦治疗4周,对照组给予恩替卡韦单药治疗。观察两组患者治疗前后临床症状、肝功能(血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶)、肝纤维化指标(血清透明质酸、层粘连蛋白、Ⅲ型前胶原、Ⅳ型胶原)等变化情况。结果:治疗组患者在乏力、腹胀、肝区不适等方面较对照组明显好转(P<0.05)。两组患者的肝功能指标在治疗后都得到改善(P<0.05),但是治疗组总胆红素(TBil)、间接胆红素(DBil)、谷氨酰转肽酶(GGT)分别下降为(60.24±20.18)μmol·L-1、(40.20±14.50)μmol·L-1、(45.20±36.24)U·L-1,与对照组比较差异具有统计学意义(P<0.05)。治疗组患者的肝纤维化各指标均较治疗前明显改善,且治疗组改善程度均优于对照组(P<0.05)。治疗组总有效率为94.29%,显著高于对照组的71.43%(P<0.05)。结论:熊去氧胆酸联合恩替卡韦治疗慢性重型肝炎伴胆汁淤积患者可起到协同作用,且安全性良好。
Objective:To observe the efficacy of ursodeoxycholic acid combined with entecavir in the treatment of chronic severe hepatitis with cholestasis.Methods:Seventy patients with chronic severe hepatitis and cholestasis were divided into two groups in this retrospective study.The treatment group received ursodeoxycholic acid plus entecavir for 4 weeks,and the control group received entecavir monotherapy.The clinical symptoms,liver function index(serum alanine aminotransferase,aspartate aminotransferase),and liver fibrosis index(serum hyaluronic acid,laminin,typeⅢprocollagen,typeⅣcollagen)before and after the treatment in the two groups of patients were observed.Results:The patients in the treatment group were significantly better than those in the control group in fatigue,bloating,and liver discomfort(P<0.05).Liver function index in both groups improved after the treatment(P<0.05).However,the levels of total bilirubin(TBil),indirect bilirubin(DBil),and glutamyl transpeptidase(GGT)decreased to(60.24±20.18)μmol·L-1,(40.20±14.50)μmol·L-1,and(45.20±36.24)U·L-1 in the treatment group,which had statistically significant differences when compared with the control group(P<0.05).The liver fibrosis indexes in the treatment group were significantly improved,and the improvements in the treatment group were better than those in the control group(P<0.05).The total effective rate of the treatment group was 94.29%,which was significantly higher than that of the control group(71.43%)(P<0.05).Conclusion:Ursodeoxycholic acid combined with entecavir can play a synergistic role for severe chronic hepatitis patients with cholestasis,and the safety was good.
作者
袁淑芳
阿依夏木古丽.沙得尔
王晴晴
刘志英
张跃新
YUAN Shu-fang;Ayxiaamuguli·Shadeer;WANG Qing-qing;LIU Zhi-ying;ZHANG Yue-xin(Department of Infectious Diseases,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Master of Science in Xinjiang Medical University,Urumqi 830000,China;Department of Pathology,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Department of Infectious Diseases,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《中国药物应用与监测》
CAS
2018年第4期201-203,222,共4页
Chinese Journal of Drug Application and Monitoring
基金
新疆维吾尔自治区自然科学基金医学联合基金项目(2015211C178)
作者简介
袁淑芳,女,主任医师,主要从事病毒性肝炎、肝衰竭等方面的研究。E-mail:13899897292@126.com;[通信作者]张跃新,男,主任医师,教授,主要从事感染性疾病方面的研究。E-mail:zhangyx3103@163.com
