肝脏 ›› 2023, Vol. 28 ›› Issue (6): 646-648.

• 肝纤维化及肝硬化 • 上一篇    下一篇

恩替卡韦联合卡维地洛治疗乙型肝炎肝硬化合并食管胃底静脉曲张的疗效

安宝燕, 郭清, 冯明洋, 徐玉敏, 蔡伟, 谢青, 王晖   

  1. 200025 上海交通大学医学院附属瑞金医院感染科
  • 收稿日期:2023-02-01 出版日期:2023-06-30 发布日期:2023-08-30
  • 通讯作者: 王晖,Email: wanghuirj@163.com

A prospective study of the efficacy of entecavir combined with carvedilol in the treatment of hepatitis B cirrhosis combined with esophagogastric varices

AN Bao-yan, GUO Qing, FENG Ming-yang, XU Yu-min, CAI Wei, XIE Qing, WANG Hui   

  1. Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-02-01 Online:2023-06-30 Published:2023-08-30
  • Contact: WANG Hui,Email: wanghuirj@163.com

摘要: 目的 探讨恩替卡韦联合卡维地洛治疗乙型肝炎肝硬化合并食管胃底静脉曲张的临床疗效。方法 选取2018年4月至2020年5月上海瑞金医院确诊治疗的乙型肝炎肝硬化合并食管胃底静脉曲张的患者35例。患者入组后继续恩替卡韦抗病毒治疗,每日给予卡维地洛10 mg口服治疗。入组后分别在基线、48周、104周进行肝功能、血常规、肝硬度、胃镜检查。结果 患者基线丙氨酸氨基转移酶(ALT)为(33.71±11.18)IU/mL、48周为(27.93±8.71)IU/mL、104周(25.57±7.18)IU/mL,48周、104周与基线比较差异均有统计学意义(P<0.05),天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰胺转移酶(GGT)差异均有统计学意义(P<0.05)。基线血小板(PLT)水平与48周无显著差异,与104周比较差异有统计学意义(P<0.05)。基线、48周、104周肝硬度分别为(18.24±8.73)kPa、(13.95±5.69)kPa、(12.12±4.20)kPa,48周和104周与基线比较差异有统计学意义(P<0.05)。入组患者治疗48周、104周与基线胃镜下食管胃底静脉曲张程度有明显改善(P<0.05)。结论 长期恩替卡韦抗病毒联合卡维地洛治疗显著改善了患者的肝硬化程度,预防了患者食管胃底静脉曲张出血。

关键词: 乙型肝炎肝硬化, 食管胃底静脉曲张, 恩替卡韦, 卡维地洛

Abstract: Objective To investigate the efficacy of entecavir combined with carvedilol in the treatment of hepatitis B virus (HBV) related cirrhosis complicated with esophagogastric varices (EGV). Methods Patients with HBV related cirrhosis complicated with EGV admitted to our hospital from April 2018 to May 2020 were selected. After enrollment, 35 patients continued entecavir antiviral therapy and were given carvedilol 10 mg orally daily.. Liver function, blood routine test, liver stiffness (LS) and gastroscope were examined at baseline, 48 weeks and 104 weeks respectively. Results The levels of alanine aminotransferase (ALT) were 33.71±11.18 IU/mL at baseline, 27.93±8.71 IU/mL at 48 weeks, and 25.57±7.18 IU/mL at 104 weeks, the differences were statistically significant (P<0.05). Similarly, aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamine transferase (GGT), baseline were significantly different from 48 weeks or 104 weeks (P<0.05). The level of platelet at baseline was not significantly different from 48 week and were significantly different from 104 week (P<0.05). The LS of patients at baseline, 48 weeks and 104 weeks were 18.24±8.73 kPa, 13.95±5.69 kPa and 12.12±4.20 kPa, respectively. There were significant differences between baseline and 48 weeks, baseline and 104 weeks (P<0.05). The degree of EGV was significantly improved at 48 weeks and 104 weeks compared to baseline (P<0.05). Conclusion Long-term antiviral therapy with entecavir combined with carvedilol significantly improved the degree of liver cirrhosis and prevented esophageal and gastric varices bleeding.

Key words: Hepatitis B cirrhosis, Esophagogastric Varices, Entecavir, Carvedilol