恩替卡韦治疗肺结核合并慢性乙型肝炎的临床观察

目的 观察恩替卡韦对肺结核合并慢性乙型肝炎患者的疗效.方法 90例肺结核合并慢性乙型肝炎患者,随机分成抗病毒治疗组45例和对照组45例.观察抗病毒治疗对肺结核合并慢性乙型肝炎患者肝功能变化、HBVDNA及患者预后的相关性.结果 抗病毒治疗组与对照组治疗后肝功能ALT、AST、GGT、ALP、TB的变化,两组差异有统计学意义(P＜0.05)；抗病毒治疗组HBVDNA转阴率为62.2％,对照组为4.44％,在治疗过程中抗病毒组无因严重肝功能损害而停止抗结核治疗者,而对照组有8例(17.8％)因严重肝功能损害而停止抗结核治疗.结论 肺结核并慢性乙型肝炎患者化疗中应用恩替卡韦抗病毒有重要意义.对改善肺结核合并慢性乙型肝炎患者的预后有重要作用.

Effect of anti-tuberculosis drugs combined with entecavir on pulmonary tuberculosis patients complicated with chronic hepatitis B

Objective To investigate the clinical effect of anti-tuberculosis drugs combined with entecavir on pulmonary tuberculosis patients complicated with chronic hepatitis B.Methods The 90 pulmonary tuberculosis patients complicated with chronic hepatitis B were randomly divided into treatment and control groups.Patients in control group were given anti-tuberculosis drug and those in treatment group were given anti-tuberculosis drug as well as oral entecavir 0.5 mg daily for nine months,The liver function changes,HBVDNA and prognosis correlation were observed.Results After treatment,the levels of ALT,AST,GGT,ALP and TB change in anti-viral treatment group and control groups were significant（P0.05）;In the antiviral therapy group,HBVDNA negative-conversion rate was 62.2%,the control group was 4.44%,In the course of treatment,the patients in antiviral group completed the full course of anti-TB treatment,while 8 cases in the control group interrupted the anti-TB treatment due to severe liver dysfunction.Conclusion Enticavir possesses marked protective effect on liver function in patients with tuberculosis and chronic hepatitis B.