摘要
目的:研究探讨替诺福韦在治疗肺结核合并慢性乙肝病毒携带者时对肝功能及HBV-DNA作用。方法:以2016年12月—2018年12月入住我科的58例肺结核合并慢性乙肝病毒携带者为研究对象,以随机的方式将两组患者分为对照组和观察组,其中对照组:共28例,均未服用替诺福韦;观察组:共30例,在肺结核化疗过程中均服用替诺福韦。比较两组患者治疗过程中的不良反应发生情况、肺结核治疗效果、肝功能、HBV-DNA及随诊情况。结果:在肺结核治疗效果、总的不良反应发生率及肺结核复发率方面,两组患者未见明显区别( P >0.05),观察组HBV-DNA定量明显较前降低( P <0.05),对照组出现恶心呕吐例数及治疗后ALT、AST、TBiL等检验结果上要明显高于观察组( P <0.05),且对照组因为肺结核治疗产生的肝损害而护肝、停止肺结核化疗甚至因为肝损害改变肺结核化疗方案的病例数要明显高于观察组,差异具有统计学意义( P < 0.05 )。结论:替诺福韦可以有效减少肺结核治疗中的肝损害发生率,并降低HBV-DNA载量。
Objective: To study the significance and influence of tenofovir in the treatment of pulmonary tuberculosis with chronic hepatitis B virus carriers. Methods: 58 cases of pulmonary tuberculosis with chronic hepatitis B virus carriers admitted to our hospital from December 2016 to December 2018 were studied.According to whether tenofovir was used in the treatment of tuberculosis, the two groups were divided into control group and observation group. Twenty-eight cases in the control group were not treated with tenofovir, while 30 cases in the observation group were treated with tenofovir during the treatment of tuberculosis. The incidence of adverse reactions, therapeutic effect of tuberculosis, liver function and follow-up were compared between the two groups. Results: There was no significant difference between the two groups in treatment effect, adverse reaction and recurrence rate of tuberculosis ( P >0.05).The quantification of HBV-DNA in the observation group was significantly decreased due to the use of antiviral drugs ( P <0.05). The number of cases of nausea and vomiting, Alt, AST, TBiL in the control group were significantly higher than those in the observation group ( P <0.05). The number of patients in the control group who changed the chemotherapy regimen for tuberculosis due to liver damage was significantly higher than that in the control group ( P < 0.05). Conclusion: Tenofovir can effectively prevent liver damage and reduce the content of HBV-DNA in the treatment of tuberculosis.
作者
蔡立莉
林小田
俞宏
李文达
吴雅婷
赵兴辉
Cai Lili(Southern Theater Naval First Hospital(Zhanjiang Guangdong 524000))
出处
《黑龙江医药》
CAS
2019年第4期782-785,共4页
Heilongjiang Medicine journal
基金
广东省湛江市科技计划项目(项目编号:2018B01129)
关键词
替诺福韦
肺结核
慢性乙肝病毒携带者
临床研究
Tenofovir
Pulmonarytuberculosis
Chronic hepatitis B virus carriers
Clinical research
