两种核苷(酸)类药物治疗乙型肝炎肝硬化伴肝源性糖尿病的疗效比较

摘要

目的:比较恩替卡韦和阿德福韦酯治疗乙型肝炎肝硬化伴肝源性糖尿病的疗效.方法:将60例乙型肝炎肝硬化伴肝源性糖尿病患者随机等分为恩替卡韦组和阿德福韦酯组.恩替卡韦组口服恩替卡韦片0.5mg,1次/d,阿德福韦酯组口服阿德福韦酯片10mg,1次/d.两组患者均给予糖尿病饮食、胰岛素控制血糖及保肝治疗.比较两组治疗48周后的肝功能、Child-Pugh评分、HBV DNA水平、肝纤维化指标(PCⅢ、Ⅳ-C、LN、HA)及糖代谢指标(FBG和HbA1c).结果:治疗后肝功能指标、Child-Pugh评分、HBV DNA水平、肝纤维化指标及糖代谢指标,恩替卡韦组均比阿德福韦酯组有改善(P<0.05).结论:恩替卡韦能有效抑制HBV复制,改善乙型肝炎肝硬化伴肝源性糖尿病患者的肝功能、Child-Pugh评分、肝纤维化指标和糖代谢指标,疗效优于阿德福韦酯.%Objective:To compare the efficacy of entecavir and adefovir dipivoxil for the treatment of hepatitis B-related cirrhosis associated with hepatogenous diabetes.Methods:60 patients with hepatitis B-related cirrhosis associated with hepatogenous diabetes were randomly assigned to the entecavir group or adefovir dipivoxil group each including 30 patients.Entecavir group received entecavir tablets 0.5 mg qd,and adefovir dipivoxil group received adefovir dipivoxil tablets 10 mg qd.Patients in both groups were given diabetic diet,blood glucose control with insulin,and liver protection.The two groups were compared for liver function indicators,Child-Pugh score,HBV DNA load,hepatic fibrosis indicators(PCⅢ,Ⅳ-C,LN,HA),and glucose metabolic indicators(FBG and HbA1c)following 48 weeks of treatment.Results:Compared to adefovir dipivoxil group,there were significant improvements in liver function indicators,Child-Pugh score,HBV DNA load,hepatic fibrosis indicators,and glucose metabolic indicators following treatment in entecavir group(P<0.05).Conclusion:Entecavir could effectively suppress HBV replication,and improve liver function,Child-Pugh score,HBV DNA load,hepatic fibrosis indicators,and glucose metabolic indicators for patients with hepatitis B-related cirrhosis associated with hepatogenous diabetes,with the efficacy superior over adefovir dipivoxil.