恩替卡韦联合苦参素治疗HBeAg阳性慢性乙型肝炎的疗效分析

Efficacy of entecavir combined with matrine in treatment of HBeAg-positive related chronic hepatitis B

摘要:

目的：观察恩替卡韦联合苦参素治疗慢性乙型肝炎的疗效。方法：将109例乙肝病毒e抗原（HBeAg）阳性的慢性乙型肝炎患者随机分为２组。治疗组（59例），给予恩替卡韦联合苦参素治疗；对照组（50例），单用恩替卡韦治疗，2组疗程均为48周。分别于治疗前、治疗第24、48周检测患者的乙肝两对半、血清HBV DNA复制、谷丙转氨酶（alanine aminotransferase，ALT）。计量资料采用t检验、秩和检验，计数资料采用?字2检验。结果：治疗组于治疗第24周时的HBeAg阴转率、HBeAg/抗HBe血清转换率、HBV DNA阴转率均显著高于对照组，差异有统计学意义（P分别为0.021、0.044、0.042）；治疗组于治疗第48周时的HBeAg阴转率、HBeAg/抗HBe血清转换率、HBV DNA阴转率显著高于对照组，差异有统计学意义（P分别为0.039、0.012、0.011）。治疗组ALT复常率分别于治疗第24、48周时与对照组的ALT复常率差异均无统计学意义（P >0.05）。结论：恩替卡韦联合苦参素治疗慢性乙肝有较好的疗效，能显著改善患者相关生化指标。

Abstract:

Objective：To observe the efficacy of entecavir combined with matrine in the treatment of HBeAg-positive related chronic hepatitis B. Methods：Totally 109 patients with HBeAg-positive related chronic hepatitis B were randomly divided into two groups.Patients in treatment group（59 cases） were treated by entecavir combined with matrine while those in control group（50 cases） were treated by entecavir singly. The treatment lasted for 48 weeks in every group. Hepatitis B two pairs of semi，serum HBV DNA repli－cation level and alanine transaminase（ALT） were detected respectively before treatment and at the 24th，48th week after treatment. Quantitative data were analyzed by t-test and rank sum test while qualitative data by chi-square test. Results：HBeAg clearance rate，HBeAg/anti-HBe seroconversion，HBV DNA recovery rate were significantly higher in treatment group than in control group at the 24th week after treatment，with significant differences between two groups（P values were 0.021，0.044，0.042 respectively）. HBeAg clearance rate，HBeAg/anti-HBe seroconversion，HBV DNA recovery rate were significantly higher in treatment group than in control group at the 48th week after treatment，with significant differences between two groups（P values were 0.039，0.012，0.011 respective－ly）. There was no statistical difference in ALT normalization rate between two groups at the 24th，48th week treatment（P >0.05）. Conclusions：Entecavir combined with matrine is effective in the treatment of chronic hepatitis B and can significantly improve the biochemical indicators of patients.