恩替卡韦对乙型肝炎肝硬化伴肝源性糖尿病患者疗效及生化指标的影响

目的 探讨恩替卡韦对乙型肝炎肝硬化伴肝源性糖尿病患者疗效及生化指标的影响。 方法 选自2012年10月-2014年10月期间金华市中心医院收治的乙型肝炎肝硬化伴肝源性糖尿病患者72例,采用随机数字表法随机分为观察组36例与对照组36例。对照组采用常规对症治疗,观察组在对照组基础上结合恩替卡韦治疗。2组疗程均为12个月。比较2组患者肝功能指标、糖代谢指标、肝纤维化指标及不良反应发生情况。 结果 2组肝功能指标白蛋白(Alb)治疗后明显增加,谷丙转氨酶(ALT)、总胆红素(TBiL)治疗后明显降低,且差异具有统计学意义(P<0.05);观察组肝功能指标Alb治疗后明显高于对照组,ALT、TBiL治疗后明显低于对照组,且差异具有统计学意义(P<0.05);2组空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)治疗后明显降低,且差异具有统计学意义(P<0.05);观察组空腹血糖、餐后2 h血糖、HbA1c治疗后明显低于对照组,且差异具有统计学意义(P<0.05);2组肝纤维化指标PC Ⅲ、HA、LN治疗后明显降低,且差异具有统计学意义(P<0.05);观察组肝纤维化指标Ⅲ型前胶原(PC Ⅲ)、透明质酸(HA)、层粘连蛋白(LN)治疗后明显低于对照组,且差异具有统计学意义(P<0.05);2组患者均未见严重不良反应,肝功能均未见加重。 结论 恩替卡韦治疗乙型肝炎肝硬化伴肝源性糖尿病患者效果明显,可明显改善患者肝功能指标和肝纤维化指标水平,具有重要临床研究价值。 

Effect of Entecavir on liver cirrhosis and hepatogenic diabetes in patients with hepatitis B and related biochemical indicators

Objective To investigate the effect of Entecavir in the treatment of liver cirrhosis and hepatogenic diabetes in patients with hepatitis B and its influence on liver function index and liver fibrosis index. Methods From October,2012 to October,2014,72 cases of liver cirrhosis and hepatogenic diabetes caused by hepatitis B in our hospital were treated,and were randomly divided into observation group (36 cases) and control group (36 cases) according to the random number table method.The control group received routine treatment,while the observation group received additional Entecavir on the basis of the treatment in the control group.The courses of both groups were 12 months.The liver function indexes,glucose metabolism indexes,liver fibrosis indexes and adverse reactions of the two groups were compared. Results Alb level of both groups were significantly increased,ALT and TBiL were significantly decreased after the treatment (P<0.05);After Alb treatment,the observation group was significantly higher than the control group,ALT,TBiL after the treatment was significantly lower than that of the control group (P<0.05);The fasting blood glucose,two-hour postprandial blood sugar,and HbA1c after the treatment in both groups was significantly reduced (P<0.05);Fasting blood glucose,two-hour postprandial blood sugar and HbA1c in the observation group were significantly lower than those in the control group (P<0.05);PCⅢ,HA and LN after the treatment of both groups was significantly reduced (P<0.05);PCⅢ,HA and LN after the treatment of the observation group was significantly lower than those in the control group (P<0.05);No serious adverse reactions were found in the two groups,and the liver function was not increased. Conclusion The effect of Entecavir in the treatment of liver cirrhosis and hepatogenic diabetes in patients with hepatitis B is obvious,it can significantly improve the liver function and hepatic fibrosis indexes of patients.So its clinical value is important.