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目的探讨乙型病毒性肝炎合并2型糖尿病患者使用干扰素抗病毒治疗的有效性与安全性。方法随机选取2013年2月—2015年2月荥阳市人民医院收治的乙型病毒性肝炎合并2型糖尿病患者50例,将其设为研究组,同期收治的乙型病毒性肝炎未合并2型糖尿病患者50例,设为对照组。研究组患者在抗病毒治疗前停用口服降糖药,统一改用注射胰岛素控制血糖,待用药1周血糖控制在正常范围后开始予以抗病毒治疗。治疗开始后的第1、12、24、36、48周检测HBV-DNA指标,并于满疗程治疗结束后,测定两组患者的空腹血糖、餐后2h血糖、糖化血红蛋白及肝功能,比较两组患者的抗病毒应答及血糖变化情况。结果治疗后研究组与对照组的ALT水平、空腹血糖、餐后2h血糖、糖化血红蛋白及HBV-DNA阴转率差异均无统计学意义(P>0.05)。结论密切监测下应用干扰素治疗乙型病毒性肝炎合并2型糖尿病是安全、有效的。
Objective To investigate the efficacy and safety of interferon antiviral therapy in patients with type 2 hepatitis B and type 2 diabetes mellitus. Methods 50 patients with type B hepatitis B and type 2 diabetes who were admitted to Shenyang People’s Hospital from February 2013 to February 2015 were selected randomly and set as the research group. Type 2 hepatitis B patients 50 patients with diabetes, as the control group. Patients in the study group discontinued oral hypoglycemic agents prior to antiviral therapy, and administered insulin injections to control blood glucose. After 1 week of glycemic control in the normal range, anti-viral therapy was started. HBV-DNA was detected on the 1st, 12th, 24th, 36th and 48th week after the start of treatment, and fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin and liver function were measured after the end of the full course of treatment. Group of patients with anti-viral response and blood glucose changes. Results After treatment, there was no significant difference in the levels of ALT, fasting blood glucose, postprandial 2h blood glucose, glycosylated hemoglobin and HBV-DNA negative conversion rate between the two groups (P> 0.05). Conclusions It is safe and effective to use interferon in the treatment of type 2 diabetes mellitus with close surveillance.