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目的:研究抗病毒及护肝治疗在肺结核(Tuberculosis,TB)合并乙肝病毒感染(Hepatitis B virus infection,HBVI)患者中的疗效。方法:选择2012年6月至2013年6月本院收治TB合并HBVI患者96例,以数字表法随机分成观察组(50例)及对照组(46例)。对照组患者予以抗病毒、抗结核治疗,观察组基于此方案另予以药物甘利欣。对比两组患者的临床疗效、肝功能指标及炎症反应。结果:观察组患者丙氨酸转氨酶(alanine aminotransferase,ALT)、天门冬氨酸转氨酶(Aspartate aminotransferase,AST)及总胆红素(Total bilirubin,T-Bil)水平在治疗第15天和第30天均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血清透明质酸(Hyaluronic acid,HA),IV型胶原(IV Collagen,IV-C)及III型前胶原(Procollagen III,PCIII)较治疗前显著降低,且显著低于对照组(P<0.05)。对照组治疗后血清HA显著降低,其余指标无统计学差异(P>0.05)。观察组疗效显著优于对照组,差异具有统计学意义(P<0.05)。结论:抗病毒及护肝方案对TB合并HBVI患者具有显著的临床疗效,能够缓解肝损害,值得临床推荐。
Objective: To study the effect of anti-virus and hepatoprotective therapy on patients with tuberculosis (TB) and hepatitis B virus infection (HBVI). Methods: A total of 96 patients with TB complicated with HBVI admitted to our hospital from June 2012 to June 2013 were randomly divided into observation group (50 cases) and control group (46 cases) by digital table method. Patients in the control group were treated with anti-virus and anti-TB drugs, and the observation group was given another drug, Glycyrrhizin, based on this program. The clinical efficacy, indexes of liver function and inflammatory reaction were compared between the two groups. Results: The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (T-Bil) in the observation group were significantly higher on the 15th and 30th day Were significantly lower than the control group, the difference was statistically significant (P <0.05). The serum levels of Hyaluronic acid (HA), IV Collagen (IV-C) and Procollagen III (PCIII) in the observation group were significantly lower than those before treatment and significantly lower than those in the control group (P <0.05). The serum level of HA in the control group decreased significantly, while the other indexes showed no significant difference (P> 0.05). The observation group was significantly better than the control group, the difference was statistically significant (P <0.05). Conclusion: The antiviral and hepatoprotective regimen has significant clinical effect on patients with TB complicated with HBVI, and can relieve liver damage, which deserves clinical recommendation.