Therapeutic effects of entecavir and adefovir dipivoxil in hepatitis B cirrhosis patients with hepatogenous diabetes:a comparative analysis
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摘要: 目的观察乙型肝炎肝硬化合并肝源性糖尿病患者分别应用恩替卡韦及阿德福韦酯抗病毒治疗的临床疗效。方法选取在青岛市传染病医院就诊的乙型肝炎肝硬化并肝源性糖尿病患者80例,根据患者所选抗病毒药物的不同,分为A、B两组,每组各40例。A组患者口服恩替卡韦0.5 mg,1次/d,B组患者口服阿德福韦酯10 mg,1次/d,抗病毒治疗48周。两组患者同时给予糖尿病饮食、胰岛素控制血糖及保肝、降酶等治疗。观察两组患者治疗前后生化学指标、病毒学应答情况、糖尿病控制情况及肝硬度等有无改善。计量资料两组间比较采用t检验。计数资料两组间比较采用χ2检验。结果恩替卡韦组患者病毒学应答率为85%(34/40),阿德福韦酯组患者病毒学应答率为65%(26/40),两组病毒学应答率差异有统计学意义(χ2=4.27,P<0.05)。恩替卡韦组患者临床生化特征改善较阿德福韦酯组更好,两组比较差异有统计学意义(P值均<0.05)。患者治疗48周后恩替卡韦组血糖及糖化血红蛋白分别为(7.53±1.13)mmol/L和(7.23±0.64)%,阿德福韦酯组血糖及糖化血红蛋白分别为(8.34±1.12)mmol/L和...Abstract: Objective To investigate the therapeutic effect of entecavir or adefovir dipivoxil as the antiviral therapy for hepatitis B cirrhosis patients with hepatogenous diabetes.Methods A total of 80 hepatitis B cirrhosis patients with hepatogenous diabetes who visited Qingdao Hospital of Infectious Diseases were enrolled,and according to the antiviral drug they chose,they were divided into group A and group B,with 40 patients in each group.The patients in group A were treated with oral administration of entecavir 0.5 mg qd,and those in group B were treated with oral administration of adefovir dipivoxil 10 mg qd.The antiviral therapy lasted for 48 weeks.The patients in both groups were given diabetic diets and insulin to control blood glucose,as well as liver- protecting and transaminase- lowering treatments.The changes in biochemical parameters,viral response,diabetes control,and the improvement in liver stiffness after treatment were observed in both groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results The viral response showed a significant difference between group A(85%,34 /40) and group B(65%,26 / 40)(χ2= 4.27,P < 0.05).Compared with group B,group A showed significant improvements in biochemical parameters(P < 0.05).After 48 weeks of treatment,group A had significantly lower levels of blood glucose and glycosylated hemoglobin than group B(blood glucose:7.53 ± 1.13 mmol / L vs 8.34 ± 1.12 mmol / L,t = 3.220,P < 0.05;glycosylated hemoglobin:7.23% ± 0.64% vs 7.79% ±0.84%,t = 3.354;P < 0.05).After the treatment,liver stiffness showed a significant difference between group A and group B(16.86 ±5.67 k Pa vs 19.47 ± 5.32 k Pa,t = 2.123,P < 0.05).Conclusion Compared with adefovir dipivoxil,entecavir can improve glycogen metabolism and blood glucose regulation through improving liver function and promoting hepatocyte repair,and finally achieve a better blood glucose control.
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Key words:
- hepatitis B virus /
- liver cirrhosis /
- hepatogenous diabetes /
- entecavir /
- adefovir dipivoxil
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