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目的:研究及观察恩替卡韦治疗乙肝相关性肾炎(HBV-GN)的临床疗效。方法:选择35例患者病理诊断均为HBV-GN,同时合并慢性乙肝或肝硬化,均给予恩替卡韦0.5mg,1次/日,口服,同时给予还原性谷胱甘肽、复方甘草酸苷等综合治疗。13例只给予还原性谷胱甘肽、复方甘草酸苷等综合治疗。12周为一疗程,24周之后对患者的各项情况进行观察分析。结果:治疗组给予恩替卡韦治疗12周后,总有效率85.71%;治疗24周后,总有效率94.29%;而对照组总有效率38.46%,两组疗效比较有显著差异(P<0.01);且治疗12周、24周后24h尿蛋白定量、血清谷丙转氨酶、血清白蛋白与治疗前比较均有明显改善(P<0.05)。结论:恩替卡韦抗病毒治疗乙肝相关性肾炎可降低患者尿蛋白,升高ALB水平,并降低ALT水平,有效缓解患者肾病综合征症状。此外,患者治疗过程中耐受性较好,无不良反应发生。
Objective: To study and observe the clinical efficacy of entecavir in the treatment of hepatitis B-related nephritis (HBV-GN). Methods: Thirty-five patients were enrolled in the study. All of them were enrolled in the study. All of them were enrolled in combination with chronic hepatitis B or cirrhosis. All patients were given entecavir 0.5 mg once a day for oral administration. The patients were given reductive glutathione and compound glycyrrhizin simultaneously treatment. Thirteen patients were given only reductive glutathione, compound glycyrrhizin and other comprehensive treatment. 12 weeks for a course of treatment, after 24 weeks of observation and analysis of the patient’s situation. Results: After treatment with entecavir for 12 weeks, the total effective rate was 85.71%. After 24 weeks of treatment, the total effective rate was 94.29%. The total effective rate was 38.46% in the control group. There was significant difference between the two groups (P <0.01). After 24 and 24 weeks of treatment, urinary protein excretion and serum alanine aminotransferase and serum albumin were significantly improved after treatment (P <0.05). Conclusion: Antiviral treatment with entecavir can reduce urinary protein, increase ALB level, decrease ALT level and relieve symptoms of nephrotic syndrome in patients with hepatitis B-associated nephritis. In addition, patients are well tolerated during treatment and no adverse reactions occur.