Objective To observe the clinical efficacy of entecavir in the treatment of hepatogenous diabetes (HD).Methods A retrospective analysis was performed on the clinical data of 72 HD patients,who were divided into treatment group (n =36) and control group (n =36).Both groups were given diabetic diet and received liver-protecting treatment,symptomatic treatment,and supportive treatment.In addition,the treatment group received oral entecavir (0.5 mg) once daily.The therapeutic effect was assessed after 52 weeks of treatment;the serum hepatitis B virus (HBV) DNA level,liver function (alanine aminotransferase,aspartate aminotransferase,total bilirubin,and albumin),blood glucose,and glycosylated hemoglobin were measured before and after treatment.The two groups were compared by t test (for measurement data) and chi-square test (for numeration data).Results After 52 weeks of treatment,29 (80.56％) of the patients in treatment group had virological response,versus 7 (19.44％) of those in control group (x2 =18.00,P ＜0.01) ; 26 (72.22％) of the patients in treatment group had liver function recovery and controlled diabetes,versus 16 (44.44％) of those in control group (x2 =5.774,P ＜ 0.05).The treatment group showed significant improvements in liver function and blood glucose after treatment (P ＜ 0.05) ; the treatment group had significantly lower glycosylated hemoglobin and fasting blood glucose than the control group (P ＜ 0.01).Conclusion In the treatment of HBV DNA-positive hepatitis B cirrhosis with HD,entecavir not only can effectively inhibit the replication of viral DNA and promote the recovery of liver function,but also can effectively control HD.%目的 观察恩替卡韦治疗肝源性糖尿病(HD)的临床疗效.方法 回顾性分析72例患者的临床资料,按是否应用恩替卡韦抗病毒治疗分为治疗组和对照组各36例.所有患者均给予糖尿病饮食及综合护肝、对症、支持治疗.治疗组给予恩替卡韦0.5 mg,口服,1次/d,观察52周的治疗效果.检测治疗前后患者血清HBV DNA水平,肝功能(ALT、AST、TBil、Alb),血糖,糖化血红蛋白等指标.两组间计量资料比较应用t检验,计数资料比较采用x2检验.结果 治疗52周后,治疗组有29例患者(80.56％)出现病毒学应答,26例(72.22％)肝功能恢复和糖尿病控制；对照组有7例患者(19.44％)出现病毒学应答,16例患者(44.44％)肝功能恢复和糖尿病控制.两组病毒学应答率及糖尿病控制率差异有统计学意义(x2=18.00,P＜0.01;x2=5.774,P＜0.05)；治疗组肝功能、血糖等指标较治疗前明显好转,差异有统计学意义(P＜0.05),治疗组患者的糖化血红蛋白、空腹血糖均低于对照组,差异有统计学意义(P＜0.01).结论 恩替卡韦治疗HBV DNA阳性的乙型肝炎肝硬化伴HD,不但能有效抑制病毒DNA复制,促进肝功能恢复,也能有效控制HD.
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