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目的研究抗病毒及护肝治疗在肺结核(TB)合并乙型肝炎病毒感染(HBVI)患者中的疗效,为临床治疗提供依据。方法选择2012年6月-2013年6月医院收治TB合并HBVI患者96例,随机分为观察组50例及对照组46例;对照组予以抗病毒、抗结核治疗,观察组基于此方案另给予药物甘利欣治疗,对比两组患者疗效、肝损害及炎症分级。结果观察组患者丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)以及总胆红素(T-Bil)水平在15d及30d时均显著低于对照组患者水平,差异均有统计学意义(P<0.05);两组患者治疗后HBsAg转阴率、HBeAg转阴率和HBV-DNA转阴率比较差异无统计学意义;治疗后观察组患者血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)较治疗前显著降低(P<0.05),对照组患者治疗后血清HA显著降低,其余指标差异无统计学意义,治疗后观察组患者血清HA、Ⅳ-C、PCⅢ显著低于对照组患者(P<0.05);观察组疗效显著优于对照组,差异有统计学意义(P<0.05)。结论抗病毒及护肝方案可显著提升TB合并HBVI患者的疗效,缓解肝损害,效果显著,值得临床推荐。
Objective To study the curative effect of anti-virus and hepatoprotective therapy in patients with pulmonary tuberculosis (TB) complicated with hepatitis B virus infection (HBVI) and provide basis for clinical treatment. Methods Sixty-six patients with TB combined with HBVI admitted from June 2012 to June 2013 in our hospital were randomly divided into observation group (n = 50) and control group (n = 46). The control group was given anti-virus and anti-TB treatment. Drugs Glycyrrhizin treatment, the efficacy of two groups were compared, liver damage and inflammation grade. Results The levels of ALT, AST and T-Bil in the observation group were significantly lower than those in the control group on the 15th and 30th days, with statistical differences (P <0.05). There was no significant difference in HBsAg negative rate, HBeAg negative rate and HBV-DNA negative rate after treatment in both groups. After treatment, serum hyaluronic acid (HA), type Ⅳ Collagen (Ⅳ-C) and type Ⅲ procollagen (PCⅢ) were significantly lower than those before treatment (P <0.05), and the serum levels of HA in the control group were significantly decreased after treatment, while the rest of the indexes showed no significant difference. , Ⅳ-C and PCⅢ in the control group were significantly lower than those in the control group (P <0.05). The curative effect in the observation group was significantly better than that in the control group (P <0.05). Conclusion The anti-virus and hepatoprotective regimen can significantly improve the curative effect of TB combined with HBVI and relieve liver damage, and the effect is significant, which is worthy of clinical recommendation.