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目的研究恩替卡韦联合保肝基础治疗对乙肝肝硬化患者HBV DNA及肝功能的影响。方法选取2012年6月—2014年7月收治的76例乙肝肝硬化患者,按照入院顺序随机分为对照组和观察组,两组各38例。对照组给予常规保肝基础治疗,观察组给予恩替卡韦联合保肝基础治疗,持续治疗1年后比较两组治疗前后HBV DNA定量检测水平和肝功能改善情况。结果治疗后观察组HBV DNA载量水平(1.95±0.46)log10拷贝/m较对照组(3.61±0.73)log10拷贝/m明显降低,具有统计学意义(P<0.05),肝功能指标ALT(28.7±6.8)U/L、AST(31.2±5.4)U/L、T—Bil(18.2±3.6)μmol/L较对照组(61.4±10.5)U/L、(57.3±6.4)U/L、(29.4±5.2)μmol/L显著较低,ALB(38.7±4.3)g/L较对照组(31.4±5.1)g/L明显提高,均具有统计学意义(P<0.05);治疗后观察组血清Hbe Ag阴转率54.17%较对照组23.81%明显较高,具有统计学意义(P<0.05)。结论乙肝肝硬化患者在常规保肝治疗基础上给予恩替卡韦联合治疗可有效减少HBV DNA载量水平和抑制病毒复制,改善肝功能ALT、AST、ALB、T-Bil等指标,且联合恩替卡韦药物治疗未增加药副作用,安全性较好。
Objective To study the effects of entecavir combined with basal liver protection on HBV DNA and liver function in patients with hepatitis B cirrhosis. Methods Sixty-six patients with hepatitis B cirrhosis who were admitted from June 2012 to July 2014 were randomly divided into control group and observation group according to admission sequence, 38 cases in each group. The control group was given conventional hepatoprotective basic treatment, while the observation group was given entecavir combined with basic hepatoprotective therapy. After one year of continuous treatment, the levels of HBV DNA and the improvement of liver function were compared between the two groups before and after treatment. Results After treatment, the level of HBV DNA in the observation group (1.95 ± 0.46) log10 copies / m was significantly lower than that in the control group (3.61 ± 0.73) log10 copies / m, with statistical significance (P <0.05) (61.4 ± 10.5) U / L and (57.3 ± 6.4) U / L, respectively, compared with the control group (± 6.8, U / L, AST 31.2 ± 5.4 U / L and T-Bil 18.2 ± 3.6 μmol / 29.4 ± 5.2) μmol / L was significantly lower than that of the control group (38.7 ± 4.3) g / L, which was significantly higher than that of the control group (31.4 ± 5.1) g / The negative rate of Hbe Ag was 54.17%, which was significantly higher than that of the control group (23.81%, P <0.05). Conclusion Combination therapy of entecavir and hepatitis B cirrhosis can reduce HBV DNA load, inhibit viral replication, improve ALT, AST, ALB, T-Bil and other indicators of liver function, and combined with entecavir drug treatment Increase drug side effects, better safety.