标题：替诺福韦酯治疗慢性乙型肝炎疗效观察

      作者：庄建奖，高海强，张友    揭西县人民医院内二科，广东 揭西 515400

      卷次： 2020年31卷9期

      【摘要】 目的 观察替诺福韦酯治疗慢性乙型肝炎的临床疗效。方法 选取2017年8月至2018年8月在揭西县人民医院内二科门诊治疗的慢性乙型肝炎患者160例，按照随机数表法将患者分为对照组和观察组，每组80例。对照组采用恩替卡韦治疗，观察组采用替诺福韦酯治疗，均治疗24周。比较两组患者治疗后的临床疗效，以及治疗前后的血清肝功能、血清炎性因子[白细胞介素-2 (IL-2)、肿瘤坏死因子-α (TNF-α)、干扰素(IFN-γ)]水平和不良反应发生情况。结果 治疗后，观察组患者的治疗总有效率为95.00%，略高于对照组的91.25%，但差异无统计学意义(P>0.05)；治疗后，两组患者的血清白蛋白、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素水平均明显低于治疗前，且观察组患者的上述指标[(58.02±10.12) U/L、(78.12±10.15) U/L、(92.12±10.48) U/L、(72.15±10.44) μmol/L]明显低于对照组[(75.12±9.48) U/L、(98.89±10.25) U/L、(104.18±10.28) U/L、(98.29±11.58) μmol/L]，差异均有统计学意义(P<0.05)；治疗后，两组患者的血清 IL-2、TNF-α、IFN-γ水平均明显低于治疗前，且观察组患者的上述指标[(5.12±0.78) ng/L、(5.02±1.02) pg/mL、(4.12±0.68) ng/L]明显低于对照组[(6.98±1.02) ng/L、(6.89±1.12) pg/mL、(5.98±0.85) ng/L]，差异均有统计学意义(P<0.05)；两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论 替诺福韦酯治疗慢性乙型肝炎能够有效改善肝功能，抑制机体炎性反应，减少不良反应，改善患者预后，具有较高的临床应用价值。
      【关键词】 慢性乙型肝炎；替诺福韦酯；肝功能；白细胞介素-2；肿瘤坏死因子-α；疗效；预后
      【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350（2020）09—1113—04

Therapeutic effect of tenofovir axetil on chronic hepatitis B.
ZHUANG Jian-jiang, GAO Hai-qiang, ZHANG You.Second Department of Internal Medicine, Jiexi People's Hospital, Jiexi 515400, Guangdong, CHINA
【Abstract】 Objective To observe the clinical effect of tenofovir dipivoxil in the treatment of chronic hepatitisB. Methods A total of 160 patients with chronic hepatitis B were selected from the Second Department of Internal Medi-cine, Jiexi People's Hospital from August 2017 to August 2018, according to the random number table. The patients weredivided into the control group and the observation group, with 80 patients in each group. The control group was treatedwith entecavir, and the observation group was treated with tenofovir dipivoxil for 24 weeks. The clinical effect of the twogroups after 24 weeks of treatment, the serum liver function, the level of serum inflammatory factors (IL-2, TNF-α,IFN-γ), and the occurrence of adverse reactions were compared. Results After treatment, the total effective rate of the ob-servation group was 95.00%, slightly higher than 91.25% of the control group, but the difference was not statistically sig-