目的 探討異甘草酸鎂注射液聯(lián)合恩替卡韋治療慢性乙型肝炎的療效及其對可溶性細(xì)胞間黏附分子-1（sICAM-1）和Fas受體（sFas）水平的影響。方法 選擇2017年10月—2020年9月在聊城市第二人民醫(yī)院治療的慢性乙型肝炎患者82例為研究對象，根據(jù)治療方法將患者分為對照組和觀察組，每組各41例。對照組口服恩替卡韋分散片，0.5 mg/次，1次/d。觀察組在對照組基礎(chǔ)上靜脈滴注異甘草酸鎂注射液，0.1 g混合250 mL生理鹽水中，1次/d，連續(xù)治療3個(gè)月。比較兩組肝功能、sICAM-1、sFas水平、不良反應(yīng)發(fā)生率、乙肝病毒的脫氧核糖核酸（HBV-DNA）、乙型肝炎E抗原（HBeAg）轉(zhuǎn)移率。結(jié)果 治療后，兩組丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸轉(zhuǎn)氨酶（AST）、總膽紅素（TbiL）和甲胎蛋白（AFP）水平均顯著降低（P<0.05）；且觀察組肝功能水平顯著低于對照組（P<0.05）。治療后，兩組sICAM-1、sFas水平均顯著低于用藥前（P<0.05）；觀察組治療后sICAM-1、sFas水平顯著低于對照組（P<0.05）。兩組用藥期間不良反應(yīng)發(fā)生率無統(tǒng)計(jì)學(xué)意義；觀察組治療后HBV-DNA、HBeAg轉(zhuǎn)陰率均高于對照組（P<0.05）。結(jié)論 異甘草酸鎂注射液聯(lián)合恩替卡韋能改善慢性乙型肝炎患者肝功能水平，能降低SICAM-1、SFas水平，未增加不良反應(yīng)發(fā)生率，可提高患者轉(zhuǎn)陰率，值得推廣應(yīng)用。

Objective To investigate the efficacy of Magnesium Isoglycyrrhizinate Injection combined with entecavir in treatment of chronic hepatitis B, and its effect on sICAM-1 and sFas levels. Methods A total of 82 patients with chronic hepatitis B from October 2017 to September 2020 in the Liaocheng Second People's Hospital were selected as the research subjects. According to the treatment methods, the patients were divided into control group and observation group, with 41 patients in each group. Patients in the control group were po administered with Entecavir Dispersible Tablets, 0.5 mg/time, once daily. Patients in the observation group were iv administered with Magnesium Isoglycyrrhizinate Injection on the basis of control group, 0.1 g mixed with 250 mL normal saline, once daily. The two groups were treated for 3 months. The liver function level, SICAM-1, SFAS level, incidence of adverse reactions, HBV DNA and HBeAg metastasis rate were compared between two groups. Results After treatment, the levels of ALT, AST, TBIL, and AFP in two groups were significantly decreased (P < 0.05). The level of liver function in observation group was significantly lower than that in control group (P < 0.05). After treatment, the levels of sICAM-1 and sFAS in two groups were significantly lower than before (P < 0.05). The levels of sICAM-1 and sFAS in observation group were significantly lower than those in control group after treatment (P < 0.05). There was no statistical significance in the incidence of adverse reactions between two groups. The negative conversion rate of HBV-DNA and HBeAg in the observation group was higher than that in the control group (P < 0.05). Conclusion Enticavir combined with Magnesium Isoglycyrrhizinate Injection can improve the level of liver function in patients with chronic hepatitis B, reduce the levels of sICAM-1 and sFAS, do not increase the incidence of adverse reactions, can improve the negative rate of patients, worthy of application.

山東省科技發(fā)展計(jì)劃項(xiàng)目（2019-1009）