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目的分析双环醇在慢性乙型肝炎合并肺结核患者临床治疗中的应用效果。方法将我院收治的100例慢性乙肝合并肺结核患者随机分为观察组50例和对照组50例。2组患者均行2HRZE/4HR标准抗结核方案治疗,在护肝治疗上,对照组患者行甘草酸二铵治疗,观察组患者则行甘草酸二铵联合双环醇治疗。统计2组患者痰菌转阴率,检测患者治疗前后的肝功能、HBV-DNA水平及血清学指标的变化情况。结果 2组患者治疗2、4、6个月后的痰菌转阴率比较,差异均无统计学意义(P均>0.05)。治疗后6个月,观察组患者的平均ALT、AST、TBIL、HBV-DNA指标水平均低于对照组(P均<0.05);观察组组内患者治疗前后的ALT、AST、TBIL指标均无明显变化(P>0.05),但治疗后HBV-DNA要低于治疗前(P<0.05)。同时,治疗后6个月,观察组患者的IL-2、IFN-γ指标水平高于对照组(P<0.05),IL-4、IL-10低于对照组(P<0.05)。结论双环醇的应用能有效保护慢性乙肝合并肺结核患者在抗结核方案治疗中的肝功能,并可能调节血清Th1/Th2亚群平衡,防止乙肝病情的加重,同时有利于提高患者抗结核治疗效果。
Objective To analyze the clinical effect of bicyclol in the treatment of patients with chronic hepatitis B complicated with pulmonary tuberculosis. Methods 100 cases of chronic hepatitis B patients with tuberculosis admitted to our hospital were randomly divided into observation group (50 cases) and control group (50 cases). Patients in both groups were treated with 2HRZE / 4HR standard anti-TB regimen. Patients in the control group received diammonium glycyrrhizinate treatment while patients in the observation group received diammonium glycyrrhizinate combined with bicyclol treatment. Statistics sputum negative rate of two groups of patients, detection of patients before and after treatment of liver function, HBV-DNA levels and changes in serological indicators. Results There was no significant difference in the negative conversion rate of sputum between the two groups after 2,4,6 months (all P> 0.05). At 6 months after treatment, the mean levels of ALT, AST, TBIL and HBV-DNA in the observation group were lower than those in the control group (all P <0.05). The ALT, AST and TBIL indexes in the observation group before and after treatment were all (P> 0.05), but the level of HBV-DNA after treatment was lower than before treatment (P <0.05). At the same time, the levels of IL-2 and IFN-γ in the observation group were significantly higher than those in the control group (P <0.05) and the levels of IL-4 and IL-10 in the observation group were lower than those in the control group (P <0.05). Conclusion The application of bicyclol can effectively protect the liver function of patients with chronic hepatitis B and pulmonary tuberculosis during anti-tuberculosis treatment and may regulate the balance of serum Th1 / Th2 subpopulation to prevent the worsening of hepatitis B and improve the anti-TB treatment effect.