恩替卡韦联合乙肝疫苗对慢性乙肝患者治疗临床研究

摘要

Objective To observe and study the clinical effect and application feasibility on entecavir combined hepatitis B vaccine in the treatment of patients with chronic hepatitis B. Methods 60 patients with chronic hepatitis B, who were received and treated in our hospital from January 2013 to June 2014, were selected to carry out prospective study, and were randomly divided into observation group which was treated with entecavir combined hepatitis B vaccine and control group which was treated with single entecavi, with 30 cases in each group. To compare the clinical treatment effect between the two groups. Results The seroconversion rate and the decrease rate of HBV DNA of patients in observation group(66.67%, 76.67%) were significantly higher than which in control group, the differences was statically significant(x2=7.62, 8.40; P < 0.05), the HBsAg titer after treatment in observation group was lower than which in control group, the surface antibody titer after treatment in observation group has significantly improved than which in control group, the differences was statically significant(t=6.98, 10.48; P<0.05). LN, HA, CIV, PCIII of liver fibrosis after treatment in observation group were lower than which in control group[(109.46±15.43)μg/L, (106.59±13.69)μg/L, (100.63±9.32)μg/L, (37.41±5.52)μg/L], the differences was statically significant(P<0.05). Conclusion Entecavir combined hepatitis B vaccine in the treatment of chronic hepatitis B has definite therapeutic effect, could effectively improve the seroconversion rate, has positive significance on the rehabilitation of disease in patients with chronic hepatitis B, has significance and valuation of clinical popularization and application.%目的：观察恩替卡韦与乙肝疫苗联合治疗慢性乙肝的临床效果与应用可行性。方法选取2013年1月～2014年6月我院收治的60例慢性乙肝患者进行前瞻性研究，将其随机分为观察组（恩替卡韦联合乙肝疫苗治疗）与对照组（单一恩替卡韦治疗）各30例，比较两组的临床治疗效果。结果观察组患者的血清转换率与HBV DNA下降率分别为66.67％、76.67％，均显著高于对照组，各项指标的组间差异有统计学意义（x2=7.62，8.40；P＜0.05）；治疗后观察组的表面抗原滴度低于对照组，表面抗体滴度较对照组有显著提升，组间比较差异显著（t=6.98，10.48；P＜0.05）；治疗后观察组的肝纤维化四项LN、HA、CIV、PCIII分别为（109.46±15.43）μg/L、（106.59±13.69）μg/L、（100.63±9.32）μg/L、（37.41±5.52）μg/L，均低于对照组，差异有统计学意义（P＜0.05）。结论应用恩替卡韦联合乙肝疫苗治疗慢乙肝的疗效确切，能有效提高血清转换率，对于慢性乙肝患者的病情康复有积极意义，具备于临床推广应用的意义与价值。