甲状腺机能亢进并乙型病毒性肝炎抗病毒治疗26例的临床分析

目的 观察甲状腺机能亢进并乙型病毒性肝炎抗病毒治疗的疗效.方法 选择甲状腺机能亢进并慢性乙型病毒性肝炎患者46例,随机分为治疗组26例和对照组20例.治疗组口服核苷(酸)类似物类药物恩替卡韦0.5 mg/d或阿德福韦酯10 mg/d,对照组不作抗病毒治疗.两组其他抗甲亢、护肝支持治疗相同.治疗前后定期检测肝功能指标和HBV-DNA.结果 两组患者治疗后肝功能指标与治疗前比较均有显著差异(P＜0.05),治疗组治疗4周后HBV-DNA平均下降104 copies/ml,对照组治疗4周后HBV-DNA无明显下降,两组治疗后肝功能指标有显著差异(P＜0.05).治疗组5例白细胞减少,对照组6例白细胞减少,均经对症处理好转;治疗组2例、对照组1例出现轻度BUN和肌酸激酶升高,随访8周未见进行性加重;治疗组19例病例随访2年,未出现明显不良反应.结论 在抗甲亢的基础上抗病毒治疗有助于甲状腺机能亢进并乙型病毒性肝炎患者肝功能恢复,两者有协同作用,抗病毒治疗是安全的.

Clinical analysis on antiviral treatment on Hyperthyroidism combine viral hepatitis b in 26 cases

Objective To observe the curative effect of antiviral treatment on hyperthyroidism combined with viral hepatitis b. Methods 26 cases diagnosed as hyperthyroidism and chronic viral hepatitis b were chosen for treatment group, 20 cases with same condition were selected as control group. The treatment group used entacavir, 0.5 mg/d or adefovir 10 mg/d orally, the control group did not make the antiviral treatment. The same support treatment of hyperthyroidism and liver was taken to two groups. Regular testing to liver function index and HBV-DNA was conducted before and after treatment. The liver function index changes were compared before and after treatment. Results Liver function indexes after treatment in two groups were obviously improved, compared with those before treatment, there was significant difference （P〈 0.05）; four weeks after treatment group hbv-dna average fell 104 copies/ml, but there was no significant differences in therapy four weeks after hbv-dna in the control group; liver function index of the treatment group compared with control group after treatment had significant difference （P 〈 0.05）. Conclusion Based on the treatment of anti-thyroid drugs, antiviral treatment can help hyperthyroidism combine viral hepatitis b patients liver function recovery, both are synergetic, antiviral treatment therapy is safe.