摘要
目的：探讨阿德福韦酯在肺结核合并乙型肝炎病毒携带者中预防肝损害的临床疗效。方法：选取2008年1月—2015年12月潜江市中心医院收治的肺结核合并乙型肝炎病毒携带者126例作为研究对象。以随机数字表法分为观察组64例和对照组62例。对照组患者给予抗结核药、肌苷片联合治疗。观察组患者在对照组的基础上,在给予抗结核药15 d前,口服阿德福韦酯10 mg,1日1次,至抗结核药停药后,再口服2个月后停药。2组患者抗结核药的疗程皆为6~9个月,观察2组患者的疗效。结果：观察组患者肝损害发生率为28.1%（18/64）,显著低于对照组的64.5%（40/62）,差异有统计学意义（P〈0.05）;治疗后,观察组患者血清乙型肝炎病毒DNA水平显著低于对照组,差异有统计学意义（P〈0.05）;观察组患者的总有效率为95.3%（61/64）,显著高于对照组的67.7%（42/62）,差异有统计学意义（P〈0.05）。结论：前瞻性应用阿德福韦酯能降低肺结核合并乙型肝炎病毒携带者在抗结核治疗中的肝损害发生率,抑制乙型肝炎病毒的复制从而减轻肝损害,有效改善患者预后。
OBJECTIVE： To probe into the clinical efficacy of application of adefovir dipivoxil in prevention of liver damage in patients with pulmonary tuberculosis combined with hepatitis B. METHODS： 126 patients with pulmonary tuberculosis combined with hepatitis B admitted into Qianjiang Central Hospital from Jan. 2008 to Dec. 2015 were selected to be divided into observation group with 64 cases and control group with 62 cases. The control group were treated with anti-tuberculosis drugs combined with inosine tablets,while before 15 days of administration of anti tuberculosis drugs,the observation group were additionally given oral administration of adefovir dipivoxil 10 mg,once a day,orally for 2 months after withdrawal of anti tuberculosis drugs. The treatment course of anti tuberculosis drugs in two groups were 6-9 months,the efficacy of two groups were observed. RESULTS： The incidence of liver damage in observation group was 28. 1%（ 18 /64）,significantly lower than that of control group [64. 5%（ 40 /62） ],with statistically significant difference（ P〈0. 05）. After treatment,the hepatitis B DNA level of observation group was significantly lower than that of control group,with statistically significant difference（ P〈0. 05）. The total effective rate of observation group was 95. 3%（ 61 /64）,significantly higher than that of control group [67. 7%（ 42 /62） ],with statistically significant difference（ P〈0. 05）. CONCLUSIONS： Prospective application of adefovir dipivoxil can reduce the liver damage in patients with pulmonary tuberculosis combined with hepatitis B by inhibiting the replication of the hepatitis B virus,which can effectively improve the prognosis in patients.
出处
《中国医院用药评价与分析》
2016年第12期1623-1625,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
阿德福韦酯
肺结核合并乙型肝炎病毒携带者
肝损害
Adefovir dipivoxil
Patients with pulmonary tuberculosis combined with hepatitis B
Liver damage
