[1]李嘉丽,温 静,周 甦,等.主动随访督导乙型肝炎肝硬化长期依从抗病毒的效果[J].医学信息,2019,32(10):178-180.[doi:10.3969/j.issn.1006-1959.2019.10.060]
　LI Jia-li,WEN Jing,ZHOU Su,et al.Active Follow-up to Monitor the Long-term Compliance with Antiviral Effects of Hepatitis B Cirrhosis[J].Journal of Medical Information,2019,32(10):178-180.[doi:10.3969/j.issn.1006-1959.2019.10.060]
点击复制

主动随访督导乙型肝炎肝硬化长期依从抗病毒的效果()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年10期
页码:
178-180
栏目:
护理研究
出版日期:
2019-05-15

文章信息/Info

Title:
Active Follow-up to Monitor the Long-term Compliance with Antiviral Effects of Hepatitis B Cirrhosis
文章编号:
1006-1959（2019）10-0178-03
作者:
李嘉丽; 温 静; 周 甦; 莫穆隆; 钟大明; 梁柱石
（广西壮族自治区梧州市第三人民医院肝病科，广西 梧州 543001）
Author(s):
LI Jia-li; WEN Jing; ZHOU Su; MO Mu-long; ZHONG Da-ming; LIANG Zhu-shi
(Department of Liver Diseases,the Third People's Hospital of Wuzhou City, Guangxi Zhuang Autonomous Region,Wuzhou 543001,Guangxi,China)
关键词:
乙型肝炎肝硬化; 肝炎症分级; 肝纤维化分期; 恩替卡韦; 随访管理
Keywords:
Hepatitis B cirrhosis; Liver inflammation grading; Liver fibrosis staging; Entecavir;  Follow-up management
分类号:
R473.5
DOI:
10.3969/j.issn.1006-1959.2019.10.060
文献标志码:
A
摘要:
目的 探索主动随访督导管理模式干预乙型肝炎肝硬化患者长期依从抗病毒治疗的效果。方法 回顾分析我院32例乙型肝炎肝硬化代偿期患者，在每个月主动随访督导2次的管理模式干预下长期用恩替卡韦抗病毒治疗的依从性，治疗后乙型肝炎病毒标志物变化情况，肝组织炎症分级及纤维化分期。结果 在主动随访中发现，有34.38%患者有中断抗病毒治疗念头，经过督导教育全都能够继续坚持治疗；经过（31.75±28.28）周治疗，所有患者HBV-DNA低于检测线下限，HBeAg阳性的患者发生转换率为45.45%；经过（305.00±147.36）周治疗后，肝组织炎症评分均值由（3.88±0.33）分降至（2.28±0.68）分，肝组织纤维化评分均值由（4.00±0.00）分降至（2.13±0.79）分，统计学意义显著（P＜0.01）；肝组织炎症与纤维化评分呈现降级改变率分别为96.88%、93.75%。结论 通过主动随访督导管理模式干预，乙型肝炎肝硬化患者能良好地长期依从抗病毒治疗，有助于长期持续抑制HBV-DNA复制，致使肝脏组织的炎症及纤维化获得减轻。
Abstract:
Objective To explore the effect of active follow-up supervision and management mode on long-term adherence to antiviral therapy in patients with hepatitis B cirrhosis. Methods A retrospective analysis of 32 patients with hepatitis B cirrhosis in our hospital, the long-term follow-up of entecavir antiviral treatment under the intervention of two consecutive management modes of monitoring, the change of hepatitis B virus markers after treatment Situation, liver tissue inflammation grade and fibrosis stage. Results In the active follow-up, 34.38% of the patients had the idea of interrupting antiviral therapy. After supervised education, they were able to continue treatment. After (31.75±28.28) weeks of treatment, all patients had lower HBV-DNA than the lower limit of detection line, HBeAg-positive The conversion rate of patients was 45.45%; after (305.00±147.36) weeks of treatment, the mean score of liver tissue inflammation score decreased from (3.88±0.33) to (2.28±0.68), and the mean liver fibrosis score was (4.00±0.00). The score was reduced to (2.13±0.79) points,the statistical significance was significant (P<0.01); the liver tissue inflammation and fibrosis scores showed a degraded rate of change of 96.88% and 93.75%, respectively. Conclusion Through active follow-up supervision and management mode intervention, patients with hepatitis B cirrhosis can long-term adherence to antiviral therapy, which can help to inhibit HBV-DNA replication for a long time, resulting in the reduction of inflammation and fibrosis of liver tissue.

参考文献/References:

[1]科技部十二五重大专项联合课题组专家.乙型肝炎病毒相关肝硬化的临床诊断、评估和抗病毒治疗的综合管理[J].中华肝脏病杂志,2014,22(5):327-335.
[2]韩莹,丁惠国.抗病毒治疗乙型肝炎肝硬化的过却、现在和将来[J].实用肝脏病杂志,2015,18(5):453-456.
[3]Li CZ,Cheng LF,Li QS,et al.Antiviral therapy delays esophageal variceal bleeding in hepatitis B virus-related cirrhosis[J].World J Gastroenterol,2013,19(40):6849-6856.
[4]徐曼曼,陈煜.慢性乙型肝炎患者抗病毒治疗依从性的研究现状[J].临床肝胆病杂志,2015,31(10):1735-1739.
[5]朱昌浩,吴元凯,李向永,等.慢性HBV感染者长期随访队列患者依从性现状及其影响因素[J].广东医学2016,37(23):3578-3582.
[6]Terrault NA,Bzowej NH,Chang KM,et al.AASLD guidelines for treatment of chronic hepatitis B[J].Hepatology,2016,63(1):261-283.
[7]Lampertico P,Agarwal K,Berg T,et al.EASL2017 clinical practice guidelines on the management of hepatitis B virus infction[J].J Hepatol,2017,67(2):370.
[8]Sarin SK,kumar M,Lau GK,et al.Asian-Pacifinc clinical practce guidelines on the management of hepatitis B:a 2015 update[J].Hepatol Int,2016,10(1):1-98.
[9]唐红梅,陈钫,杨红艳,等.抗病毒治疗患者治疗依从性及用药满意度调查[J].中华现代护理杂志,2013,19(2):160-162.
[10]刘湘云,田晓慧.医护药责任一体化管理对口服乙型肝炎抗病毒药物患者依从性的影响[J].蚌埠医学院学报,2016,41(3):395-397.
[11]赵艳,张伯鹏,张国顺.慢性乙型肝炎核苷类药物治疗依从性影响因素Logistic回归分析[J].中西医结合肝病杂志,2013,23(5):309-311
[12]王月云.慢性乙型病毒性肝炎患者治疗依从性及其影响因素分析[J].系统医学,2016,1(9):44-46.
[13]梁嘉仪,杨小安,张卡,等.核苷(酸)类药物治疗慢性乙型肝炎患者不同巩固治疗期的停药复发率[J].中华实验和临床病毒学杂志,2016,30(5):486-489.
[14]区淑华,陈永鹏,姜荣龙,等.核苷(酸)类药物治疗慢性乙型肝炎停药后复发相关肝衰竭预后分析[J].中华肝脏病杂志,2016,24(4):252-257.
[15]高媛媛,赵娟,武婷.慢性乙肝患者抗病毒治疗依从性中存在的问题分析[J].临床心身疾病杂,2016,22(z1):397.

相似文献/References:

[1]姜海燕.恩替卡韦联合复方甘草酸苷治疗乙型肝炎肝硬化对患者肝功能及血清HA、Ⅳ-C、PC-Ⅲ水平的影响[J].医学信息,2022,35(09):144.[doi:10.3969/j.issn.1006-1959.2022.09.036]
　JIANG Hai-yan.Effect of Entecavir Combined with Compound Glycyrrhizin on Liver Function and Serum Levels of HA, Ⅳ-C and PC-Ⅲ in Patients with Hepatitis B Cirrhosis[J].Journal of Medical Information,2022,35(10):144.[doi:10.3969/j.issn.1006-1959.2022.09.036]
[2]李安乐,戴 夫,彭 琼.中性粒细胞与淋巴细胞比值、红细胞体积分布宽度与乙型肝炎及乙型肝炎肝硬化的关系研究[J].医学信息,2019,32(03):69.[doi:10.3969/j.issn.1006-1959.2019.03.022]
　LI An-le,DAI Fu,PENG Qiong.Relationship between Neutrophil-lymphocyte Ratio,Red Blood Cell Volume Distribution Width and Hepatitis B and Hepatitis B Cirrhosis[J].Journal of Medical Information,2019,32(10):69.[doi:10.3969/j.issn.1006-1959.2019.03.022]

更新日期/Last Update: 2019-05-15