恩替卡韦对慢性乙型肝炎肝纤维化患者的疗效及对MMP—9水平的影响(1)
【摘要】 目的：探討恩替卡韦对慢性乙型肝炎(CHB)肝纤维化患者的疗效及对基质金属蛋白酶(MMP-9)水平的影响。方法：选取2014年10月-2016年10月期间于本院就诊的慢性乙型肝炎肝纤维化患者74例为研究对象。采用随机数字分组法将其分为对照组和观察组，每组各37例。对照组给予降酶、抗肝纤维化、抗HBV病毒及免疫抑制等常规治疗，观察组在对照组基础上给予恩替卡韦进行治疗，观察两组患者治疗后肝纤维化指标、肝功能及MMP-9等变化情况，HbsAg、HBV-DNA转阴率以及ALT复常率情况。结果：观察组治疗后总有效率91.89%；对照组总有效率72.97%，观察组总有效率明显高于对照组(P<0.05)。两组患者治疗前透明质酸酶(HA)、层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、Ⅳ胶原(C-Ⅳ)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)、基质金属蛋白酶-9(MMP-9)指标比较差异均无统计学意义(P>0.05)；治疗后各指标均有明显改善(P<0.05)，观察组治疗后HA、LN、PC-Ⅲ、C-Ⅳ、ALT、MMP-9水平明显低于对照组(P<0.05)。两组患者治疗后HbsAg转阴率比较差异无统计学意义(P>0.05)；观察组治疗后HBV-DNA转阴率及ALT复常率明显高于对照组(P<0.05)。结论：恩替卡韦可有效改善CHB肝纤维化患者肝纤维化指标及肝功能状况、降低MMP-9水平、提高HBV-DNA转阴率及ALT复常率，临床疗效显著，值得推广应用。
【关键词】 恩替卡韦； 慢性乙型肝炎； 肝纤维化； MMP-9； 临床疗效
【Abstract】 Objective：To investigate the effect of Entecavir on the liver fibrosis in patients with chronic hepatitis B and the effect on the level of MMP-9.Method：74 patients with chronic hepatitis B fibrosis in our hospital from October 2014 to October 2016 were selected as the subjects.They were divided into the control group and the observation group by the random digital grouping method，37 cases in each group.The control group was given routine treatment，such as reducing Enzyme，anti liver fibrosis，anti HBV virus and immunosuppression.The observation group was treated with Entecavir on the basis of the control group.The changes of liver fibrosis index， liver function and MMP-9，HbsAg，HBV-DNA negative rate and ALT recurrence rate were observed in two groups after treatment.Result：The total effective rate of the observation group was 91.89%，the total effective rate of the control group was 72.97%，the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Before treatment，compared the levels of patients HA，LN，PC-Ⅲ，C-IV，ALT，AST，TBIL，ALB and MMP-9 of two groups showed no significant difference(P>0.05)；the indexes were significantly improved after treatment(P<0.05)；the levels of HA，LN，PC-Ⅲ，C-IV，ALT，MMP-9 in observation group after treatment significantly lower than the control group(P<0.05).The two groups of patients after treatment HbsAg negative rate showed no significant difference(P>0.05)；the observation group after treatment HBV-DNA negative rate and the recovery rate of ALT were significantly higher than the control group(P<0.05).Conclusion：Entecavir can effectively improve liver fibrosis index and liver function， reduce MMP-9
level， improve HBV-DNA negative rate and ALT recurrence rate in patients with CHB liver fibrosis，which is worthy of clinical application., 百拇医药(张文汉 左军 何祖顺 张凯)
【关键词】 恩替卡韦； 慢性乙型肝炎； 肝纤维化； MMP-9； 临床疗效
【Abstract】 Objective：To investigate the effect of Entecavir on the liver fibrosis in patients with chronic hepatitis B and the effect on the level of MMP-9.Method：74 patients with chronic hepatitis B fibrosis in our hospital from October 2014 to October 2016 were selected as the subjects.They were divided into the control group and the observation group by the random digital grouping method，37 cases in each group.The control group was given routine treatment，such as reducing Enzyme，anti liver fibrosis，anti HBV virus and immunosuppression.The observation group was treated with Entecavir on the basis of the control group.The changes of liver fibrosis index， liver function and MMP-9，HbsAg，HBV-DNA negative rate and ALT recurrence rate were observed in two groups after treatment.Result：The total effective rate of the observation group was 91.89%，the total effective rate of the control group was 72.97%，the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).Before treatment，compared the levels of patients HA，LN，PC-Ⅲ，C-IV，ALT，AST，TBIL，ALB and MMP-9 of two groups showed no significant difference(P>0.05)；the indexes were significantly improved after treatment(P<0.05)；the levels of HA，LN，PC-Ⅲ，C-IV，ALT，MMP-9 in observation group after treatment significantly lower than the control group(P<0.05).The two groups of patients after treatment HbsAg negative rate showed no significant difference(P>0.05)；the observation group after treatment HBV-DNA negative rate and the recovery rate of ALT were significantly higher than the control group(P<0.05).Conclusion：Entecavir can effectively improve liver fibrosis index and liver function， reduce MMP-9
level， improve HBV-DNA negative rate and ALT recurrence rate in patients with CHB liver fibrosis，which is worthy of clinical application., 百拇医药(张文汉 左军 何祖顺 张凯)
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