恩替卡韦治疗乙型肝炎肝硬化合并肝源性糖尿病的临床观察

苟卫; 王燕玲; 徐筱玮; 徐文伟

恩替卡韦治疗乙型肝炎肝硬化合并肝源性糖尿病的临床观察

1. 青岛大学医学院
2. 青岛市传染病医院门诊部
3. 青岛海慈医疗集团内分泌科

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2371
- HTML全文浏览量: 26
- PDF下载量: 571
- 被引次数: 0
出版历程
- 出版日期: 2013-06-20

Clinical efficacy of entecavir in treatment of hepatogenous diabetes

Medical College of Qingdao University

摘要

摘要:
目的观察恩替卡韦治疗肝源性糖尿病(HD)的临床疗效。方法回顾性分析72例患者的临床资料,按是否应用恩替卡韦抗病毒治疗分为治疗组和对照组各36例。所有患者均给予糖尿病饮食及综合护肝、对症、支持治疗。治疗组给予恩替卡韦0.5 mg,口服,1次/d,观察52周的治疗效果。检测治疗前后患者血清HBV DNA水平,肝功能(ALT、AST、TBil、Alb),血糖,糖化血红蛋白等指标。两组间计量资料比较应用t检验,计数资料比较采用χ2检验。结果治疗52周后,治疗组有29例患者(80.56%)出现病毒学应答,26例(72.22%)肝功能恢复和糖尿病控制;对照组有7例患者(19.44%)出现病毒学应答,16例患者(44.44%)肝功能恢复和糖尿病控制。两组病毒学应答率及糖尿病控制率差异有统计学意义(χ2=18.00,P<0.01;χ2=5.774,P<0.05);治疗组肝功能、血糖等指标较治疗前明显好转,差异有统计学意义(P<0.05),治疗组患者的糖化血红蛋白、空腹血糖均低于对照组,差异有统计学意义(P<0.01)。结论恩替卡韦治疗HBV DNA阳性的乙型肝炎肝硬化伴HD,不...
- 恩替卡韦 /
- 肝源性糖尿病 /
- 肝炎,乙型 /
- 肝硬化
Abstract:
Objective To observe the clinical efficacy of entecavir in the treatment of hepatogenous diabetes (HD) .Methods A retrospective analysis was performed on the clinical data of 72 HD patients, who were divided into treatment group (n=36) and control group (n=36) .Both groups were given diabetic diet and received liver-protecting treatment, symptomatic treatment, and supportive treatment.In addition, the treatment group received oral entecavir (0.5 mg) once daily.The therapeutic effect was assessed after 52 weeks of treatment;the serum hepatitis B virus (HBV) DNA level, liver function (alanine aminotransferase, aspartate aminotransferase, total bilirubin, and albumin) , blood glucose, and glycosylated hemoglobin were measured before and after treatment.The two groups were compared by t test (for measurement data) and chi-square test (for numeration data) .Results After 52 weeks of treatment, 29 (80.56%) of the patients in treatment group had virological response, versus 7 (19.44%) of those in control group (χ2 = 18.00, P<0.01) ;26 (72.22%) of the patients in treatment group had liver function recovery and controlled diabetes, versus 16 (44.44%) of those in control group (χ2=5.774, P<0.05) .The treatment group showed significant improvements in liver function and blood glucose after treatment (P<0.05) ;the treatment group had significantly lower glycosylated hemoglobin and fasting blood glucose than the control group (P<0.01) .Conclusion In the treatment of HBV DNA-positive hepatitis B cirrhosis with HD, entecavir not only can effectively inhibit the replication of viral DNA and promote the recovery of liver function, but also can effectively control HD.
- entecavir /
- hepatogenous diabetes /
- hepatitis B /
- liver cirrhosis

HTML全文

参考文献(13)

[1]Tak P, Kate F.Remission of active diabetic hepatitis after correc-tion of hyperglycemia[J].Liver, 1993, 13 (4) :183.

[2]Park SH, Kim DJ, Lee HY.Insulin resistance is not associated withhistologic severity in nondiabetic, noncirrhotic patients with chronichepatitis B virus infection[J].Am J Gastroenterol, 2009, 104 (5) :1135-1139.

[3]Nakai T, Tanimura H, Hirokawa F, et al.Altered hepatic hemody-namics and improved liver function following in trahepatic vascularinfusion of prostag land in E1[J].J Gastroenterol, 1998, 33 (3) :362-367.

[4]Zhang WW, Wang XQ, Li Y.Insulin resistance and serum growthhormone level in patients with cirrhosis[J].World Chin J Dig, 2002, 10 (10) :1180-1183. (in Chinese) 张卫卫, 王学清, 李岩.肝硬化胰岛素抵抗及血清生长激素水平的研究[J].世界华人消化杂志, 2002, 10 (10) :1180-1183.

[5]Chinese Society of Infectious Diseases and Parasitology and ChineseSociety of Hepatology of Chinese Medical Association.Preventionand treatment of viral hepatitis[J].Chin J Hepatol, 2000, 8 (6) :324-329. (in Chinese) 中华医学会传染病与寄生虫病学分会, 肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329.

[6]Han YH, Li ST.Clinical Hepatology[M].Jinan:Shandong Sci-ence and Technology Press, 2004:6. (in Chinese) 韩硬海, 李树桐.临床肝脏病学[M].济南:山东医学技术出版社, 2004:6.

[7]Edvardsson U, von Lwenhielm HB, Panfilov O, et al.Hepaticprotein expression of lean mice and obese diabetic mice treated withperoxisome proliferator-activated receptor activators[J].Pro-teomics, 2003, 3 (4) :468-478.

[8]Zhao JJ, Zhang ZF.Therapeutic efficacy of adefovir dipivoxil intreatment of hepatitis B cirrhosis with hepatogenous diabetes[J].JClin Hepatol, 2009, 25 (1) :46-47. (in Chinese) 赵建军, 张志峰.阿德福韦酯治疗乙型肝炎肝硬化伴肝源性糖尿病的疗效观察[J].临床肝胆病杂志, 2009, 25 (1) :46-47.

[9]Wang HN, Wen WB.Progress in clinical research on hepatogenousdiabetes[J].J Clin Hepatol, 2003, 6 (1) :59-60. (in Chinese) 王华宁, 温伟波.肝源性糖尿病临床研究进展[J].实用肝脏病杂志, 2003, 6 (1) :59-60.

[10]Han HM.Current situation of research on pathogenesis of hepatoge-nous diabetes[J].J Clin Hepatol, 2006, 22 (2) :152-153. (inChinese) 韩红梅.肝源性糖尿病发病机制的研究现状[J].临床肝胆病杂志, 2006, 22 (2) :152-153.

[11]YU MX, Yin HM, Li YJ, et al.The treatment status of hepatoge-nous diabetes[J].J Clin Hepatol, 2011, 27 (7) :779-782. (inChinese) 于明霞, 尹威民, 李迎今, 等.肝源性糖尿病的治疗现状[J].临床肝胆病杂志, 2011, 27 (7) :779-782.

[12]Gao AH, Wang XL, Jiang QH, et al.Clinical observation on influ-ence of livweiwuling tablets combined with entecavir on chronic hep-atitis B patients with HBeAg positive[J].Chin J Liver Dis (Elec-tren Vers) , 2011, 3 (1) :35-37. (in Chinese) 高爱华, 王新丽, 姜清河, 等.六味五灵片联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者的疗效观察[J].中国肝脏病杂志 (电子版) , 2011, 3 (1) :35-37.

[13]Li L, Cheng J, Ji D.Research progress in treatment of hepatogenousdiabetes[J].World Chin J Dig, 2004, 12 (7) :1659-1662. (inChinese) 李莉, 成军, 纪冬.肝源性糖尿病的治疗研究进展[J].世界华人消化杂志, 2004, 12 (7) :1659-1662.

施引文献

资源附件(0)

访问统计