恩替卡韦联合HBsAg纳米乳剂治疗慢性乙型肝炎的疗效研究

目的:观察恩替卡韦联合HBsAg纳米乳剂治疗慢性乙型肝炎(乙肝)的临床疗效.方法:我院2015年9月-2016年4月收治的慢性乙型病毒性肝炎患者60例,随机分为联合治疗组和恩替卡韦治疗组,每组30例.在保肝治疗的基础上,恩替卡韦治疗组单独给予恩替卡韦治疗,联合治疗组给予恩替卡韦联合HBsAg纳米乳剂口服,比较两组HBV DNA转阴率、HBeAg转阴率以及肝功能(丙氨酸转氨酶和总胆红素)的变化.结果:治疗3个月和治疗6个月后,联合治疗组的HBV DNA水平均较恩替卡韦治疗组明显下降(P＜0.05);治疗6个月后,联合治疗组患者的血清病毒转阴率与HBeAg抗原转阴率分别为(90.00％和26.67％)均显著高于恩替卡韦治疗组(46.67％和3.33％),差异均有统计学意义(P＜0.01).治疗后3个月和6个月联合治疗组的丙氨酸转氨酶和总胆红素均明显低于治疗前,也明显低于恩替卡韦治疗组,差异均有统计学意义(P＜0.05).但联合治疗组有1例治疗后肝功能指标恶化.结论:应用恩替卡韦联合HBsAg纳米乳剂治疗慢性乙型肝炎能有效提高血清乙肝病毒转阴率和HBeAg转阴率,改善肝功能,较单用恩替卡韦治疗效果更好;对其安全性还要加强观察.

The therapeutic effect of entecavir combined with HBsAg nanoemulsion for chronic hepatitis B

Objective:To observe the clinical effect ofentecavir combined with HBsAg nanoemulsion in treatment of patients with chronic hepatitis B.Methods:Sixty patients with chronic hepatitis B admitted in the 163rd Hospital of PLA during Sep.2015 to Apr.2016 were randomly assigned into two groups (30 each):based on liver protection treatment,patients in combination group were treated with entecavir combining HBsAg nanoemulsion,and those in control group were treated with entecavir only.The negative rate of HBV DNA and HBeAg,and the levels of alanine aminotransferase (ALT) and total bilirubin (TBIL) were compared between the two groups.Results:The HBV DNA level significantly decreased in combination group than in control group 3 and 6 months after treatment (P＜0.05).The negative conversion rates of serum virus and the HBeAg in combination group (90.00％ and 26.67％) were significantly higher than that in control group (46.67％ and 3.33％) 6 months after treatment (P＜0.01).The liver function (levels of ALT and TBIL) in combination group was significantly lower 3 and 6 months after treatment than that before treatment (P＜0.05) and that in control group (P＜0.05).But the liver function was aggravated in one case of combination group.Conclusions:Entecavir combined with HBsAg nanoemulsion in treatment of chronic hepatitis B may effectively increase the negative conversion rates of serum virus and HBeAg,and improve the liver function compared to that in control group,but the safety of HBsAg nanoemulsion should be closely noticed.