摘要
目的探究复方丹参片联合恩替卡韦对乙型肝炎肝硬化患者血清降钙素原及肝纤维化标志物的影响。方法选取确诊乙型肝炎肝硬化患者62例,采用随机数字表法分为2组,每组31例。对照组予恩替卡韦治疗,治疗组在对照组基础上予复方丹参片治疗,治疗12个月。检测治疗前后血清降钙素原(PCT)、肝功能及肝纤维化标志物的变化,观察其临床疗效及安全性。结果与治疗前比较,2组血清PCT、ALT、AST、TBIL及HBV-DNA水平均降低(P<0.05),PCⅢ、Ⅳ-C、LN、HA水平均降低(P<0.05);与对照组相比较,治疗组血清PCT及PCⅢ、Ⅳ-C、LN、HA水平均较低(P<0.05),ALT、AST、TBIL及HBV-DNA均较低(P<0.01),临床疗效较高(P<0.01)。结论复方丹参片联合恩替卡韦对乙型肝炎肝硬化有较好的临床疗效,可有效降低血清PCT水平,显著改善肝功能及肝纤维化。
Objective To explore effect of compound danshen tablets combined with entecavir on hepatitis B liver cirrhosis in patients with serum procalcitonin and liver fibrosis markers. Methods 62 patients with hepatitis B cirrhosis were selected and randomly divided into control group and treatment group,31 cases in each group. Control group was treated with entecavir,treatment group were treated on the basis of control group combined with compound danshen tablets for 12 months treatment. Serum levels of PCT,liver function and liver fibrosis markers and clinical efficacy and safety were compared pre-and post-treatment. Results Compared with pre treatment,serum PCT,ALT,AST,TBIL and HBV-DNA level were decreased( P <0. 05),PC III,IV-C,LN and HA levels were decreased( P < 0. 05); compared with control group,serum PCT and PC III,IV-C,LN and HA levels in treatment group were lower( P < 0. 05),ALT,AST,TBIL and HBV-DNA were lower( P < 0. 01),the clinical efficacy was higher( P < 0. 01).Conclusion Compound danshen tablets combined with entecavir for liver fibrosis in patients with hepatitis B has better clinical efficacy,can effectively reduce the serum PCT levels,significantly improve the liver function and liver fibrosis.
引文
[1]谢玉宝,池晓玲,萧焕明,等.从运气学说探讨甲午年慢性乙型肝炎肝纤维化的诊治规律[J].中华中医药杂志,2014,29(3):662-665.
[2]陈洁,张欣欣.乙型肝炎病毒特征与肝硬化及原发性肝细胞癌关系的研究进展[J].中华肝脏病杂志,2014,22(2):153-155.
[3]沈涛,张保秀,刘华兴,等.西双版纳西部某地乙型肝炎病毒感染的血清学调查[J].中华传染病杂志,2014,32(4):240-243.
[4]石志平,吴同玉.乙型肝炎肝硬化发病机制特点研究概况[J].辽宁中医药大学学报,2014,16(1):91-94.
[5]董红筠,高斌,王敬,等.乙型肝炎肝硬化合并上消化道出血患者医院感染的相关因素分析[J].中华医院感染学杂志,2014,24(8):1955-1957.
[6]肖兴国,吴慧丽,李琨琨.恩替卡韦对乙型肝炎后肝硬化患者肝功能及肿瘤标志物影响研究[J].中国生化药物杂志,2015,35(4):88-90.
[7]中华医学会肝病学分会.慢性乙型肝炎防治指南(2015更新版)[J].中华肝脏病杂志,2015,23(12):888-905.
[8]崔玲,甄真.宿主免疫状态对慢性乙型肝炎抗病毒治疗效果的影响[J].中华传染病杂志,2014,32(5):313-317.
[9]常青山.恩替卡韦分散片与恩替卡韦片治疗乙型肝炎肝硬化的对比研究[J].中国医院用药评价与分析,2014,14(11):990-992.
[10]官亮,邓欢,龚辉,等.恩替卡韦联合胸腺法新对HBe Ag阴性慢性乙型肝炎患者病毒动力学的影响[J].中国老年学杂志,2014,34(23):6791-6792.
[11]刘芬,王系伟.恩替卡韦初始抗病毒治疗慢性乙型肝炎患者5年发生基因型耐药1例[J].中华肝脏病杂志,2013,21(10):781-782.
[12]谢函君,叶志伟.恩替卡韦联合中药治疗慢性乙型肝炎肝纤维化40例[J].中西医结合肝病杂志,2014,24(5):307-309.
[13]陈晓艳,范妮.和络舒肝胶囊与复方丹参片改善肝纤维化疗效比较[J].中外医学研究,2013,11(12):22-23.
[14]黄莉霞,甘绍军.血清肝纤维化四项检测在慢性肝病中的临床分析[J].世界最新医学信息文摘:连续型电子期刊,2015,15(1):134.
[15]李楚天,何青莲,罗碧怡,等.慢性肝炎患者肝脏炎症程度与肝纤维化的关系[J].广东医学,2014,35(17):2713-2714.
[16]李积杰.老年乙型肝炎患者肝硬化危险因素[J].中国老年学杂志,2015,35(13):3684-3686.