目的 观察硫普罗宁联合替比夫定治疗慢性乙型肝炎的临床疗效。方法 收集2014年1月—2015年5月在中国石油天然气集团公司中心医院感染科门诊及北京佑安医院重症肝病科门诊接受治疗的慢性乙型肝炎患者80例,随机分为对照组和治疗组,每组各40例。对照组患者口服替比夫定片,600 mg/次,1次/d。治疗组在对照组治疗基础上口服硫普罗宁肠溶片,0.2 g/次,3次/d。两组均连续治疗18周。观察两组的临床疗效,同时比较两组治疗前后天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、丙氨酸氨基转氨酶(ALT)、总胆红素(TBil)、层黏蛋白(LN)、透明质酸酶(HA)、Ⅲ型胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为72.5%、90.0%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者ALT、AST、GGT、TBil、HA、LN、C-Ⅳ、PCⅢ均显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 硫普罗宁联合替比夫定治疗慢性乙型肝炎取得了良好的效果,可显著改善患者肝功能,降低患者的肝纤维化指标,具有一定的临床推广应用价值。

Objective To observe the effect of tiopronin combined with telbivudine in treatment of chronic hepatitis B. Methods Patients (80 cases) with chronic hepatitis B in Department of Infectious Disease of Central Hospital of China National Petroleum Corporation and Department of Severe Liver Disease of Beijing YouAn Hospital from January 2014 to May 2015 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were po administered with Telbivudine Tablets, 600 mg/time, once daily. The patients in the treatment group were po administered with Tiopronin Enteric-coated Tablets on the basis of control group, 0.2 g/time, three times daily. The patients in two groups were treated for 18 weeks. After treatment, the clinical efficacy was evaluated, and the changes of AST, GGT, ALT, TBil, LN, HA, PCⅢ, and Ⅳ-C in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.5% and 90.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, ALT, AST, GGT, TBil, HA, LN, C-Ⅳ, and PCⅢ in two groups was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tiopronin combined with telbivudine has good effect in treatment of chronic hepatitis B, and can significantly improve liver function, also can reduce the fibrosis indexes of patients liver, which has a certain clinical application value.