恩替卡韦联合利拉鲁肽治疗乙肝肝硬化伴肝源性糖尿病患者的临床疗效和安全性研究

摘要/Abstract

摘要： 目的观察恩替卡韦联合利拉鲁肽治疗乙肝肝硬化伴肝源性糖尿病患者的临床疗效和安全性。方法选取2018年5月~2019年5月鄂尔多斯市中医医院收治的100例乙肝肝硬化伴肝源性糖尿病患者为研究对象,以随机数表法分为试验组和对照组,每组50例。试验组患者用恩替卡韦联合利拉鲁肽治疗,对照组患者用利拉鲁肽治疗。分析治疗前后患者的肝功能、血糖水平和不良反应发生率,评价使用不同药物治疗乙肝肝硬化伴肝源性糖尿病患者的临床疗效和安全性。结果治疗后,患者直接胆红素（DBIL）、丙氨酸氨基转移酶（ALT）、谷草转氨酶（AST）、总胆红素（TBiL）的水平均呈现下降趋势,试验组显著低于对照组,差异有统计学意义（P<0.05）;治疗后,患者糖化血红蛋白（HbA_1c）、空腹血糖（FBG）、餐后2 h血糖（2 hPBG）水平均呈下降趋势,试验组显著低于对照组,差异有统计学意义（P<0.05）;两组患者不良反应发生率比较,差异无统计学意义（P>0.05）。结论在利拉鲁肽的基础上给予恩替卡韦具有显著抗病毒作用,不仅可以改善患者肝功能,还可辅助降低患者血糖,且不良反应小,安全性高,值得临床应用。

关键词: 乙肝肝硬化, 恩替卡韦, 利拉鲁肽, 肝源性糖尿病

Abstract: Objective To observe the clinical efficacy and safety of entecavir combined with liraglutide in the treatment of patients with hepatitis B cirrhosis and hepatogenic diabetes. Methods One hundred patients with hepatitis B cirrhosis and liver-derived diabetes were divided into a test group（routine treatment + Entecavir + liraglutide treatment） and a control group（routine treatment and liraglutide） with a random number table method, each with 50 cases. We were admitted to our hospital from May 2018 to May 2019. By analyzing the liver function, blood glucose level, and incidence of adverse reactions of patients before and after treatment, the clinical efficacy and safety of different drugs in the treatment of patients with hepatitis B cirrhosis and hepatogenic diabetes were evaluated. Results After treatment, the levels of direct bilirubin（DBIL）, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, and total bilirubin（TBiL） of the subjects showed a downward trend, and the test group was significantly lower than the control group（P<0.05）; After treatment, the levels of glycosylated hemoglobin（HbA_1c）, fasting blood glucose（FBG）, and 2 h postprandial blood glucose（2 hPBG） of the subjects showed a downward trend. The test group was significantly lower than the control group（P<0.05）. There was no significant difference in incidence ofadverse reactions between the two groups（P>0.05）. Conclusion The administration of entecavir and liraglutide can reduce the adverse reactions and blood glucose, and improve the antiviral effects, liver function and treatment safety. This method is worthy of clinical application and promotion.

Key words: Hepatitis B cirrhosis, Entecavir, Liraglutide, Liver-derived diabetes

中图分类号:

张亚楠, 李静. 恩替卡韦联合利拉鲁肽治疗乙肝肝硬化伴肝源性糖尿病患者的临床疗效和安全性研究[J]. 中华养生保健, 2022, 40(2): 3-6.

ZHANG Ya-Nan, LI Jing. Study on the clinical efficacy and safety of entecavir combined with liraglutide in the treatment of patients with hepatitis B cirrhosis and hepatogenic diabetes[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(2): 3-6.

参考文献

[1] 葛冰景,肖铁刚,周薏,等.逍遥散联合恩替卡韦治疗肝郁脾虚型乙肝后肝硬化代偿期30例临床研究[J].江苏中医药,2020,52(11):28-31.
[2] 李朝晖,张晓龙,郭彦清,等.安络化纤丸联合恩替卡韦治疗乙肝肝硬化的效果及对肝功能的影响[J].中国医药导报,2020,17(28):151-154.
[3] 陈岚,张蓉.恩替卡韦单药替代拉米夫定与阿德福韦酯对乙肝肝硬化患者肾脏的影响研究[J].重庆医学,2020,49(15):2533-2537.
[4] 宋香妮,曹娟.恩替卡韦联合前列地尔治疗乙肝肝硬化合并肝源性糖尿病临床效果分析[J].陕西医学杂志,2020,49(9):1145-1148.
[5] 狄书杰,夏茜.和络舒肝片联合恩替卡韦对活动性代偿期乙肝肝硬化患者的临床疗效[J].中成药,2020,42(6):1486-1489.
[6] 乔兵,周永,史昌河,等.肝源性糖尿病诊疗进展[J].中国肝脏病杂志(电子版),2016,8(3):21-25.
[7] 王海蓉. 肝爽颗粒联合恩替卡韦治疗代偿期乙型肝炎肝硬化患者临床研究[J].中国药物与临床,2020,20(5):760-762.
[8] 朱凤云,蒋明光,涂玲玲,等.恩替卡韦与阿德福韦酯治疗乙肝肝硬化患者的疗效及预后比较[J].安徽医学,2018,39(11):1314-1317.
[9] 袁媛,陈洁,杨雪梅,等.国产恩替卡韦对HBeAg阳性代偿期乙肝肝硬化患者HBV复制的抑制效果、血清球蛋白及补体C3、C4的影响研究[J].川北医学院学报,2020,35(3):432-435,449.
[10] Vu T, Vallabh M, Laine G.Adrenal insufficiency and response to stress dose hydrocortisone in patients with cirrhosis and vasopressor dependency using cirrhosis-specific cortisol thresholds[J]. Ann Pharmacother,2020,54(8):742-749.
[11] Shiomi M, Tanaka Y, Takada T, et al.Determining whether the effect of liraglutide on non-alcoholic fatty liver disease depends on reductions in the body mass index[J]. JGH Open,2020,4(5):995-1001.
[12] Kwo P, Dronamraju D.More evidence that direct acting antiviral therapy is safe and effective in cirrhosis and chronic kidney disease including peritoneal dialysis[J]. Clin Mol Hepatol,2020,26(4):489-491.
[13] 薛李娜,诸国兵.恩替卡韦分散片对乙型肝炎肝硬化失代偿期患者疗效的探讨[J].系统医学,2020,5(20):50-52.
[14] 陈曦,任浩,陈照林,等.苦参碱联合恩替卡韦抗乙型肝炎病毒感染的作用及其机制[J].现代生物医学进展,2018,18(18):3518-3520.
[15] 丁志祥. 恩替卡韦治疗乙型肝炎肝硬化合并糖尿病患者的疗效观察[J].海峡药学,2019,31(12):119-120.