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目的探讨聚乙二醇干扰素α-2a联合恩替卡韦对慢性乙型肝炎病人肝功能及肝纤维化的影响。方法将70例慢性乙型肝炎病人分为观察组和对照组,各35例。全部病人给予常规综合治疗,对照组采用恩替卡韦治疗,观察组采用聚乙二醇干扰素α-2a联合恩替卡韦治疗,比较两组病人肝功能及肝纤维化程度。结果观察组总有效为88.57%,对照组为62.86%,两组比较差异有统计学意义(χ~2=6.293,P<0.05);两组治疗后总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)均显著降低(P<0.05);观察组治疗后AST、ALT、TBil、GGT显著低于对照组治疗后,差异有统计学意义(t=5.410、7.084、7.414、2.460,P<0.05);两组治疗后透明质酸酶(HA)、Ⅲ型前胶原(PCⅢ)、层连黏蛋白(LN)、IV型肽原(Ⅳ-C)均显著降低(P<0.05);观察组治疗后HA、PCⅢ、LN、Ⅳ-C显著低于对照组治疗后,差异有统计学意义(t=14.194、3.666、3.896、4.362,P<0.05);两组均未出现明显的全身或局部不良反应。结论聚乙二醇干扰素α-2a联合恩替卡韦能显著提高慢性乙型肝炎病人的肝功能,逆转肝纤维化进程。
Objective To investigate the effects of pegylated interferon α-2a combined with entecavir on liver function and liver fibrosis in patients with chronic hepatitis B. Methods 70 cases of chronic hepatitis B patients were divided into observation group and control group, each 35 cases. All patients were given conventional comprehensive treatment. The control group was treated with entecavir. The observation group was treated with peginterferon alfa-2a combined with entecavir. The liver function and the degree of liver fibrosis in both groups were compared. Results The total effective rate was 88.57% in the observation group and 62.86% in the control group. The difference between the two groups was statistically significant (χ ~ 2 = 6.293, P <0.05). The total bilirubin (TBil), alanine ALT, AST and GGT were significantly decreased (P <0.05). The levels of AST, ALT, TBil and GGT in the observation group were significantly lower than those in the control group After treatment, the difference was statistically significant (t = 5.410,7.084,7.414,2.460, P <0.05). The levels of hyaluronidase (HA), type Ⅲ procollagen (PCⅢ), laminin (P <0.05). The levels of HA, PCⅢ, LN and Ⅳ-C in the observation group were significantly lower than those in the control group after treatment (t = 14.194,3.666,3.896,4.362, P <0.05). No obvious systemic or local adverse reactions occurred in both groups. Conclusion Pegylated interferon α-2a combined with entecavir can significantly improve the liver function in patients with chronic hepatitis B and reverse the process of liver fibrosis.