【摘要】：目的觀察恩替卡韋聯(lián)合阿德福韋酯治療慢性乙肝的效果,并探討其作用機(jī)制。方法選擇慢性乙肝患者84例,隨機(jī)分為觀察組、對照組各42例。兩組均常規(guī)給予保肝、對癥支持治療,對照組在此基礎(chǔ)上口服阿德福韋酯10 mg、每日1次,觀察組口服阿德福韋酯10 mg及恩替卡韋0.5 mg、每日1次。兩組療程均為6個月。觀察治療后的臨床效果,比較兩組治療前后肝功能及血清IL-10、IFN-γ水平的變化,并記錄兩組治療期間的不良反應(yīng)。結(jié)果治療6個月后,觀察組總有效率為90.5%,對照組為73.8%,兩組比較差異有統(tǒng)計學(xué)意義(χ2=6.273,P0.05)。治療6個月后,觀察組ALT、AST、TBIL、GGT較治療前顯著降低,且低于對照組治療后(P均0.01)。治療6個月后,觀察組血清IL-10水平較治療前顯著降低,且低于對照組治療后(P0.01);血清IFN-γ水平較治療前顯著升高,且高于對照組治療后(P0.01)。治療期間,兩組不良反應(yīng)癥狀較輕,不影響治療。結(jié)論恩替卡韋聯(lián)合阿德福韋酯治療慢性乙肝的效果較好,能顯著改善患者的肝功能;其機(jī)制可能是通過促進(jìn)IL-10的分泌而減輕肝細(xì)胞局部炎癥反應(yīng)及通過Th1細(xì)胞分泌的IFN-γ在轉(zhuǎn)錄水平抑制乙肝病毒復(fù)制。
[Abstract]:Objective to observe the effect of entecavir combined with adefovir ester in the treatment of chronic hepatitis B and to explore its mechanism. Methods 84 patients with chronic hepatitis B were randomly divided into observation group (n = 42) and control group (n = 42). Both groups were given liver protection and symptomatic support therapy. On this basis, the control group was given adefovir 10 mg, once a day, while the observation group was given adefovir 10 mg and entecavir 0.5 mg, once a day. The course of treatment in both groups was 6 months. To observe the clinical effect after treatment, to compare the changes of liver function and serum IL-10,IFN- 緯 level between the two groups before and after treatment, and to record the adverse reactions of the two groups during treatment. Results after 6 months of treatment, the total effective rate was 90.5% in the observation group and 73.8% in the control group. There was significant difference between the two groups (蠂 2 鈮，

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