摘要
目的:探讨核苷类似物治疗乙型肝炎肝硬化并发食管静脉曲张临床价值。方法:选取乙型肝炎肝硬化并发食管静脉曲张患者88例,根据是否抗病毒治疗分为对照组(33例)和治疗组(55例)。比较两组患者治疗前后肝功能指标[白蛋白(ALB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]、Child-Pugh评分和凝血功能指标[凝血酶原时间(PT)、凝血酶原活动度(PTA)]以及治疗后乙型肝炎病毒DNA(HBV-DNA)阴转率、食管静脉曲张程度和消化道出血情况。结果:抗病毒治疗后,治疗组患者TBIL、ALT、AST较治疗前降低,ALB较治疗前升高(均P<0.05)。抗病毒治疗后,治疗组患者PT较治疗前降低,且治疗组低于对照组;治疗组PTA较治疗前升高,且治疗组高于对照组(均P<0.05)。治疗组抗病毒治疗后Child-Pugh评分较治疗前降低,且治疗组Child-Pugh评分低于对照组(均P<0.05)。与对照组比较,治疗组在抗病毒治疗后HBV-DNA阴转率升高(P<0.05)。在未行EVL治疗患者中,治疗组食管静脉曲张减轻程度高于对照组(P<0.05)。在接受及未接受EVL治疗的患者中,治疗组消化道出血率低于对照组(均P<0.05)。结论:核苷类似物能够抑制乙型肝炎肝硬化并发食管静脉曲张患者HBV病毒复制,改善肝功能和凝血功能,减轻食管静脉曲张程度,降低消化道出血风险。
Objective:To investigate the clinical value of nucleoside analogues in the treatment of hepatitis B cirrhosis complicated with esophageal varices.Methods:Eighty-eight patients with hepatitis B cirrhosis complicated with esophageal varices were selected and divided into control group(33 cases)and treatment group(55 cases)according to whether antiviral treatment was given.Liver function indexs(albumin[ALB],alanine aminotransferase[ALT],aspartate aminotransferase[AST],total bilirubin[TBIL]),Child-Pugh score and coagulation function indexes(prothrombin time[PT],prothrombin activity[PTA])were compared between the two groups before and after treatment.The negative conversion rate of hepatitis B virus DNA(HBV-DNA),the degree of esophageal varices and gastrointestinal bleeding were compared between two groups after treatment.Results:After antiviral treatment,TBIL,ALT and AST in treatment group were lower than before treatment,and ALB was higher than before treatment(all P<0.05).After antiviral treatment,PT in the treatment group was lower than before treatment,and the treatment group was lower than the control group.PTA in the treatment group was higher than that before treatment,and the treatment group was higher than the control group(all P<0.05).After antiviral treatment,the Child-Pugh score of the treatment group was lower than that before treatment,and the Child-Pugh score of the treatment group was lower than that of the control group(all P<0.05).Compared with the control group,the negative conversion rate of HBV-DNA in the treatment group was increased after antiviral treatment(P<0.05).In patients who did not receive EVL treatment,the reduction degree of esophageal varices in the treatment group was higher than that in the control group(P<0.05).In patients who received EVL and those who did not receive EVL,the rate of gastrointestinal bleeding in the treatment group was lower than that in the control group(all P<0.05).Conclusion:Nucleoside analogues can inhibit HBV virus replication in patients with hepatitis B cirrhosis complicated with esophageal varices,improve liver function and coagulation function,reduce the degree of esophageal varices,and reduce the risk of gastrointestinal bleeding.
作者
王婷
邹百仓
董蕾
薛琼
王进海
陈芬荣
WANG Ting;ZOU Baicang;DONG Lei;XUE Qiong;WANG Jinhai;CHEN Fenrong(Department of Gastroenterology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《陕西医学杂志》
CAS
2024年第5期671-674,共4页
Shaanxi Medical Journal
基金
陕西省重点研发计划项目(2022SF-460)。
关键词
肝硬化
乙型肝炎病毒
食管静脉曲张
核苷类似物
消化道出血
Cirrhosis
Hepatitis B virus
Esophageal varices
Nucleoside analogues
Gastrointestinal bleeding
