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目的探讨核苷类似物联合糖皮质激素治疗高转氨酶慢性乙型肝炎患者的意义。方法随机选取本院88例高转氨酶慢性乙型肝炎患者,将其分为两组,对照组43例,给予常规内科治疗;观察组45例,在常规治疗的基础上加用核苷类似物联合糖皮质激素治疗,比较两组患者的治疗疗效及联合治疗的临床意义。结果观察组治疗总有效率高达97.78%,显著高于对照组(74.42%),差异有统计学意义(P<0.05);观察组血清生化指标:谷丙转氨酶(ALT)、总胆红素(TBIL)显著低于对照组,白蛋白(ALB)、凝血酶原时间(PT)显著高于对照组,差异均有统计学意义(P<0.05);观察组ALT复常率、乙肝病毒的脱氧核糖核酸(HBV-DNA)阴转率与乙型肝炎e抗原(HBeAg)血清转换率分别为62.22%、53.33%与13.33%,均显著高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论核苷类似物联合糖皮质激素治疗慢性乙型肝炎的疗效佳,显著改善血清生化指标与肝功能,不良反应与并发症低,是一种有效、安全的治疗方式。
Objective To investigate the significance of nucleoside analogue combined with glucocorticoid in the treatment of patients with chronic hepatitis B with high transaminase. Methods A total of 88 patients with chronic hepatitis B with high transaminase were randomly divided into two groups, 43 patients in the control group received routine medical treatment. The observation group consisted of 45 patients treated with nucleoside analogues Glucocorticoid treatment, the treatment of two groups were compared and the clinical significance of combination therapy. Results The total effective rate of the observation group was 97.78%, significantly higher than that of the control group (74.42%), the difference was statistically significant (P <0.05). The serum biochemical indexes of the observation group were: ALT and total bilirubin TBIL) was significantly lower than the control group, albumin (ALB), prothrombin time (PT) was significantly higher than the control group, the difference was statistically significant (P <0.05); observation group ALT normalization rate of hepatitis B virus deoxy The seroconversion rates of HBV DNA and HBeAg were 62.22%, 53.33% and 13.33% respectively, which were significantly higher than those of the control group (P <0.05) ; The incidence of complications in the observation group were significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion The combination of nucleoside analogues and glucocorticoids in the treatment of chronic hepatitis B has a good curative effect, significantly improves serum biochemical indexes and liver function, and has low adverse reactions and complications. It is an effective and safe treatment.