中国医学创新2025，Vol.22Issue(15)：23-28,6.DOI:10.3969/j.issn.1674-4985.2025.15.006
抗病毒联合优化抗结核治疗方案对肺结核合并HBV-DNA低拷贝乙肝携带者的影响
Effect of Anti-viral Combined Optimization of Anti-tuberculosis Therapy on HBV Carriers with Pulmonary Tuberculosis and Low HBV-DNA Copies
摘要
Abstract
Objective:To investigate the effect of anti-virus combined with optimized anti-tuberculosis therapy on HBV carriers with pulmonary tuberculosis and low copies of HBV-DNA.Method:From January 2021 to December 2022,120 patients with pulmonary tuberculosis and hepatitis B carriers with low HBV-DNA copies who were admitted to Jiangxi Provincial Chest Hospital were selected and divided into three groups by random number table method,the control group(n=37)was treated with standard quadruple anti-tuberculosis treatment regimen,the test group 2(n=40)was treated with optimized anti-tuberculosis treatment regimen,and the test group 1(n=43)was treated with anti-hepatitis B virus drug(Entecavir)combined with optimized anti-tuberculosis treatment regimen.The changes of pulmonary tuberculosis and the negative conversion of HBV markers in the three groups were compared,the changes of serum indexes before and after treatment in the three groups were compared,and the liver damage and adverse reactions in the three groups were counted.Result:The lesion absorption rate of test group 1 and test group 2 was higher than that of the control group,the lesion absorption rate of test group 1 was higher than that of test group 2,and the sputum bacterial conversion rate of test group 1 was higher than that of the control group(P<0.05).Hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg)and HBV-DNA conversion rate of test group 1 were higher than those of test group 2 and control group(P<0.05).After 1 month of treatment,serum aspartate aminotransferase(AST),alanine aminotransferase(ALT),and HBV-DNA in test group 1 were lower than those in test group 2 and the control group,and serum ALT and AST in test group 2 were lower than those in the control group(P<0.05).The cumulative incidences of drug-induced liver injury(DILI)after 1 month,3 and 6 months of treatment in test group 1 were lower than those in test group 2 and the control group(P<0.05).The incidence of adverse reactions in test group 1(13.95%)was lower than that in the control group(40.54%)(P<0.05).Conclusion:The optimized anti-tuberculosis treatment regimen combined with antiviral therapy can significantly improve the absorption rate of tuberculosis lesions,effectively inhibit HBV-DNA replication,reduce liver damage,and has few adverse reactions.关键词
肺结核/乙型肝炎病毒/优化抗结核治疗/抗病毒治疗/肝损伤Key words
Pulmonary tuberculosis/Hepatitis B virus/Optimized anti-tuberculosis treatment/Antiviral therapy/Liver damage引用本文复制引用
刘㑇,吴于青,蔡国庆,姜国强,廖永美..抗病毒联合优化抗结核治疗方案对肺结核合并HBV-DNA低拷贝乙肝携带者的影响[J].中国医学创新,2025,22(15):23-28,6.基金项目
江西卫生健康委科技计划项目(202130959) （202130959）
