恩替卡韦治疗合并肺结核的慢性乙型肝炎效果观察

朱栋梁; 李道波; 赵满芝; 马科; 宋建新; 许东

doi:10.3969/j.issn.1001-5256.2016.11.014

恩替卡韦治疗合并肺结核的慢性乙型肝炎效果观察

DOI: 10.3969/j.issn.1001-5256.2016.11.014

1. 华中科技大学同济医学院附属同济医院感染科
2. 湖北省公安县中医院肝病科

基金项目:

湖北省自然科学基金资助项目(2013CFB077)；

详细信息

中图分类号: R512.62;R521
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出版历程
- 出版日期: 2016-11-20

Clinical effect of entecavir in treatment of patients with chronic hepatitis B complicated by tuberculosis

Research funding:

摘要

摘要:
目的探索恩替卡韦抗病毒治疗在慢性乙型肝炎（CHB）合并肺结核患者抗结核治疗过程中的有效性。方法回顾性分析2007年6月-2013年12月华中科技大学同济医学院附属同济医院收治的95例CHB合并肺结核患者,按是否在抗结核治疗的同时行恩替卡韦抗病毒治疗分为治疗组（n=38）和对照组（n=57）,对其治疗前后临床生化指标等的变化情况及转归等进行比较。计量资料组间比较采用t检验或Mann-Whitey U检验,计数资料组间比较采用χ2检验。结果治疗过程中,对照组患者ALT、AST显著高于治疗组[(382.7（260.7635.9）U/L vs 143.3（97.9260.4）U/L,Z=-4.225,P<0.001;280.7（197.6461.8）U/L vs93.8（67.3156.9）U/L,Z=-4.637,P<0.001],TBil显著升高[157.4（139.7269.6）μmol/L vs(106.8（88.3187.1）μmol/L,Z...
- 肝炎,乙型,慢性 /
- 结核 /
- 恩替卡韦 /
- 治疗
Abstract:
Objective To investigate the clinical effect of entecavir in the treatment of patients with chronic hepatitis B( CHB) complicated by tuberculosis during anti- tuberculosis treatment. Methods A retrospective study was performed for the clinical data of 95 patients with CHB complicated by tuberculosis,and according to the application of entecavir antiviral therapy during anti- tuberculosis treatment,these patients were divided into treatment group and control group. The changes in clinical biochemical parameters and prognosis after treatment were compared between the two groups. The t- test or Mann- Whitney U test were used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results During the treatment,compared with the treatment group,the control group had significantly higher alanine aminotransferase [382. 7( 260. 7- 635. 9) U / L vs 143. 3( 97. 9-260. 4) U / L,Z =- 4. 225,P < 0. 001] and aspartate aminotransferase [280. 7( 197. 6- 461. 8) U / L vs 93. 8( 67. 3- 156. 9) U / L,Z =- 4. 637,P < 0. 001]and significant increases in total bilirubin [157. 4( 139. 7- 269. 6) μmol / L vs 106. 8( 88. 3- 187. 1) μmol / L,Z =- 2. 671,P = 0. 008] and the proportion of patients with jaundice( 63. 2% vs 34. 2%,χ2= 7. 650,P = 0. 007). Compared with the treatment group,the control group had a significantly prolonged prothrombin time( 22. 5 ± 15. 5 s vs 17. 3 ± 9. 7 s,t = 2. 553,P = 0. 012)and a significantly lower platelet count [( 131. 0 ± 69. 4) × 109/ L vs( 181. 7 ± 105. 6) × 109/ L,t = 2. 826,P = 0. 004] during treatment.Compared with the treatment group,the control group had significant increases in the proportions of patients with liver failure( 42. 1% vs15. 8%,χ2= 7. 306,P < 0. 001) and patients who were forced to stop all or part of antitubercular agents due to liver impairment during treatment( withdrawal of all antitubercular agents: 17. 5% vs 2. 6%,χ2= 4. 952,P = 0. 026; withdrawal of part of antitubercular agents: 68. 4%vs 15. 8%,χ2= 25. 330,P < 0. 001). Conclusion During the anti- tuberculosis treatment for patients with CHB complicated by tuberculosis,entecavir antiviral therapy can effectively reduce the incidence of liver injury during anti- tuberculosis treatment and ensure the effect and safety of anti- tuberculosis treatment; therefore,it holds promise for further clinical research.
- hepatitis B,chronic /
- tuberculosis /
- entecavir /
- therapy

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参考文献(16)

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