不同治疗方案的恩替卡韦联合抗结核药物治疗肺结核合并慢性乙肝的临床疗效及安全性<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2025.06.004

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Abstract 【Objective】 To explore the clinical efficacy and safety of entecavir combined with antitubercular drugs in different treatment regimens for pulmonary tuberculosis complicated with chronic hepatitis B.【Methods】 A retrospective analysis was performed on the clinical data of 120 newly diagnosed patients with pulmonary tuberculosis complicated with chronic hepatitis B admitted to Jiangxi Chest hospital from January 2021 to June 2023. According to different treatment regimens, the patients were divided into the control group (n=32),the observation group A (n=47), and the observation group B (n=41). The treatment efficacy and incidence of adverse reactions were compared among the three groups. The levels of serum total bilirubin (TBIL), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (GGT) were compared before and after treatment. The HBV-DNA levels were compared before treatment, at 6 months, 12 months of treatment, and 3 months after drug withdrawal. 【Results】 The total clinical effective rates of observation group A and observation group B were higher than that of the control group, with statistically significant differences (P<0.05). After treatment, the serum TBIL and ALT levels in observation group A and observation group B were higher than those before treatment, the GGT levels were lower than those before treatment, and the serum TBIL, ALT, and GGT levels were all lower than those in the control group, with statistically significant differences (P<0.05). At 6 months, 12 months of treatment, and 3 months after drug withdrawal, the HBV-DNA levels in observation group A and observation group B were lower than those in the control group, with statistically significant differences (P<0.05). The incidences of adverse reactions in the three group were no significant differences (P>0.05). 【Conclusion】 For patients with pulmonary tuberculosis complicated with chronic hepatitis B taking antitubercular drugs, continuing antiviral therapy after treatment according to the principles of "early, regular, combined, appropriate, and full-course" can achieve better clinical efficacy and better safety.

Key words： Tuberculosis, Pulmonary Hepatitis B, Chronic Antiviral Agents Antitubercular Agents Treatment Outcome

Received: 31 March 2025

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R521

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.06.004 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I6/923

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