目的 觀察硫普羅寧聯(lián)合替比夫定治療慢性乙型肝炎的臨床療效。方法 收集2014年1月—2015年5月在中國(guó)石油天然氣集團(tuán)公司中心醫(yī)院感染科門(mén)診及北京佑安醫(yī)院重癥肝病科門(mén)診接受治療的慢性乙型肝炎患者80例,隨機(jī)分為對(duì)照組和治療組,每組各40例。對(duì)照組患者口服替比夫定片,600 mg/次,1次/d。治療組在對(duì)照組治療基礎(chǔ)上口服硫普羅寧腸溶片,0.2 g/次,3次/d。兩組均連續(xù)治療18周。觀察兩組的臨床療效,同時(shí)比較兩組治療前后天門(mén)冬氨酸氨基轉(zhuǎn)移酶(AST)、谷氨酰轉(zhuǎn)肽酶(GGT)、丙氨酸氨基轉(zhuǎn)氨酶(ALT)、總膽紅素(TBil)、層黏蛋白(LN)、透明質(zhì)酸酶(HA)、Ⅲ型膠原(PCⅢ)、Ⅳ型膠原(Ⅳ-C)的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為72.5%、90.0%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者ALT、AST、GGT、TBil、HA、LN、C-Ⅳ、PCⅢ均顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 硫普羅寧聯(lián)合替比夫定治療慢性乙型肝炎取得了良好的效果,可顯著改善患者肝功能,降低患者的肝纖維化指標(biāo),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the effect of tiopronin combined with telbivudine in treatment of chronic hepatitis B. Methods Patients (80 cases) with chronic hepatitis B in Department of Infectious Disease of Central Hospital of China National Petroleum Corporation and Department of Severe Liver Disease of Beijing YouAn Hospital from January 2014 to May 2015 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Telbivudine Tablets, 600 mg/time, once daily. The patients in the treatment group were po administered with Tiopronin Enteric-coated Tablets on the basis of control group, 0.2 g/time, three times daily. The patients in two groups were treated for 18 weeks. After treatment, the clinical efficacy was evaluated, and the changes of AST, GGT, ALT, TBil, LN, HA, PCⅢ, and Ⅳ-C in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.5% and 90.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, ALT, AST, GGT, TBil, HA, LN, C-Ⅳ, and PCⅢ in two groups was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tiopronin combined with telbivudine has good effect in treatment of chronic hepatitis B, and can significantly improve liver function, also can reduce the fibrosis indexes of patients liver, which has a certain clinical application value.