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替比夫定在慢性HBV感染合并肺结核患者抗结核治疗中减轻肝损害的临床观察 被引量:5

Telbivudine alleviates liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with chronic HBV infections
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摘要 目的 观察替比夫定在HBV DNA阳性慢性HBV感染合并肺结核患者抗结核治疗过程中减轻肝损害的作用.方法 选择2011年6月至2013年12月武汉市黄陂区人民医院收治的HBV DNA阳性慢性HBV感染合并肺结核患者68例.按数字表法将所有患者随机分为2组,联合治疗组(35例)在抗结核治疗的同时给予替比夫定抗病毒治疗,单纯抗结核治疗组(33例)仅接受抗结核治疗.采用x2检验或秩和检验比较两组患者接受抗结核治疗后肝损害的发生率、调整或中止抗结核治疗率及HBV再激活率.结果 联合治疗组有5例(5/35,14.29%)患者发生肝损害,而单纯抗结核治疗组有15例(15/33,45.45%)患者发生肝损害,两组比较差异有统计学意义(x2=7.95,P<0.05).联合治疗组有1例(1/35,2.86%)调整抗结核治疗方案,而单纯抗结核治疗组有13例(13/33,39.39%)调整或中止抗结核治疗,两组比较差异有统计学意义(x2=13.87,P<0.01).联合治疗组有2例(2/35,5.71%)患者发生HBV再激活,而单纯抗结核治疗组有10例(10/33,30.30%)患者发生HBV再激活,两组HBV再激活率比较差异也有统计学意义(x2=7.34,P<0.01).结论 替比夫定在HBV DNA阳性慢性HBV感染合并肺结核患者抗结核治疗中减轻肝损害有一定的作用. Objective To investigate the alleviation effect of telbivudine on liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection.Methods A total of 68 pulmonary tuberculosis patients with HBV DNA positive chronic HBV infection were enrolled from Huangpi People' s Hospital during June 2011 and December 2013.Patients were randomly assigned to receive antitubercular plus telbivudine treatment (combination group,n =35) or antitubercular treatment only (single group,n =33).Chi-square and rank sum tests were performed to compare the incidence of liver damages,adjustment or termination of antitubercular treatment,and HBV reactivations between two groups.Results Liver damage was observed in 5 patients (5/35,14.29%) of combination group and in 15 patients (15/33,45.45%) of single group (x2 =7.95,P 〈 0.05).One patient (1/35,2.86%) in combination group adjusted the therapy,while 13 patients (13/33,39.39%) in single group adjusted or terminated treatment (x2 =13.87,P 〈0.01).HBV reactivation occurred in 2 patients (2/35,5.71%) of combination group,but in 10 patients (10/33,30.30%) of single group (x2 =7.34,P 〈 0.01).Conclusion Telbivudine can effectively alleviate liver dysfunction during antitubercular treatment in pulmonary tuberculosis patients with HBV DNA positive chronic HBV infections.
出处 《中华临床感染病杂志》 CAS 2014年第3期235-238,共4页 Chinese Journal of Clinical Infectious Diseases
关键词 肝炎病毒 乙型 结核 抗结核药 药物性肝损伤 替比夫定 Hepatitis B virus Tuberculosis,pulmonary Antitubercular agents Drug-induced liver injury Telbivudine
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