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目的:观察恩替卡韦联合复方鳖甲软肝片对HBV DNA阳性慢性乙型肝炎患者脾脏弹性指数和门静脉内径的影响。方法:HBV DNA阳性慢性乙型肝炎患者64例,治疗组36例,对照组28例。治疗组恩替卡韦联合复方鳖甲软肝片治疗,对照组恩替卡韦治疗。每3个月查肝功能、甲胎蛋白、HBV DNA、两对半、血常规,上腹部B超检测肝脏和脾脏的弹性指数、门静脉内径,共4次。结果:治疗3个月,两组HBV DNA均已转阴,肝功能、甲胎蛋白、血常规基本正常,肝、脾弹性指数和门静脉内径与基线比无差异;治疗6、9个月,两组血清学检测结果同3个月,但肝、脾弹性指数和门静脉内径与治疗3个月比较,差异有统计学意义,治疗组治疗6、9个月与基线及治疗3个月比较,肝、脾弹性指数和门静脉内径差异有统计学意义;对照组肝、脾弹性指数和门静脉内径与治疗3个月及基线比较无统计学差异;治疗12个月两组肝、脾弹性指数和门静脉内径差异有统计学意义。结论:对HBV DNA阳性慢性乙型肝炎肝纤维化患者进行抗病毒联合抗纤维化治疗后,肝、脾弹性指数和门静脉内径改善的疗效优于单纯抗病毒治疗。
Objective: To observe the effect of entecavir and Fufang Biejiarangan Tablets on spleen elasticity index and portal vein diameter of HBV DNA positive chronic hepatitis B patients. Methods: Sixty-four patients with HBV DNA positive chronic hepatitis B, 36 patients in the treatment group and 28 patients in the control group. The treatment group entecavir combined with Fufang Biejia Ruangan Tablet treatment, the control group entecavir treatment. Liver function, alpha-fetoprotein, HBV DNA, two-and-a-half, blood routine, and abdominal ultrasonography were used to check the liver and spleen’s elasticity index and portal vein diameter every 3 months for 4 times. Results: After 3 months of treatment, HBV DNA in both groups had been negative, liver function, alpha-fetoprotein and blood routine were basically normal. There was no difference between the indexes of elasticity of liver and spleen and the diameter of portal vein compared with baseline. After treatment for 6 and 9 months, The results of serological test were the same as those of 3 months. However, the indexes of elasticity of liver and spleen and the diameter of portal vein were significantly different from those of 3 months. The difference was statistically significant between the treatment group and the baseline and the 3 months after treatment , Spleen elasticity index and portal vein diameter difference were statistically significant; control group liver, spleen elasticity index and portal vein diameter and treatment of 3 months and no significant difference between baseline; treatment of 12 months liver and spleen elasticity index and portal vein diameter The difference was statistically significant. Conclusion: The effect of improving liver and spleen elasticity index and portal vein diameter is better than that of antiviral therapy after antiviral combined with anti-fibrosis treatment in patients with HBV DNA-positive chronic hepatitis B liver fibrosis.