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目的：研究抗病毒及护肝治疗在肺结核（Tuberculosis，TB）合并乙肝病毒感染（Hepatitis B virus infection，HBVI）患者中的疗效。方法：选择2012 年6 月至2013 年6 月本院收治TB 合并HBVI患者96 例，以数字表法随机分成观察组（50例）及对照组（46 例）。对照组患者予以抗病毒、抗结核治疗，观察组基于此方案另予以药物甘利欣。对比两组患者的临床疗效、肝功能指标及炎症反应。结果：观察组患者丙氨酸转氨酶（alanine aminotransferase，ALT）、天门冬氨酸转氨酶（Aspartate aminotransferase，AST）及总胆红素（Total bilirubin，T-Bil）水平在治疗第15 天和第30 天均显著低于对照组，差异有统计学意义（P＜0.05）。观察组患者治疗后血清透明质酸（Hyaluronic acid，HA），IV 型胶原（IV Collagen，IV-C）及III型前胶原（Procollagen III，PCIII）较治疗前显著降低，且显著低于对照组（P<0.05）。对照组治疗后血清HA 显著降低，其余指标无统计学差异（P＞ 0.05）。观察组疗效显著优于对照组，差异具有统计学意义（P＜0.05）。结论：抗病毒及护肝方案对TB 合并HBVI 患者具有显著的临床疗效，能够缓解肝损害，值得临床推荐。

英文摘要:

Objective:To study and discuss the curative effect of anti-virus and liver protection therapy in the treatment of patients with tuberculosis (TB) combined with hepatitis B virus infection (HBVI).Methods:96 patients with HBVI combined with TB who were treated in our hospital from June 2012 to June 2013 were selected and randomly divided into the observation group (n=50) and the control group (n=46). The patients in the control group were given the anti-viral and anti-tuberculosis drugs regimen, while the patients in the observation group were treated with drugs Ganlixin besides the basic drug regimen. Then the curative effect, the liver damage and inflammation classification were compared between the two groups.Results:ALT, AST, and T-Bil levels of the observation group after 15d and 30d were significantly lower than those of the control group with statistically significant differences(P<0.05). After treatment, the serum HA, IV-C and PCIII in the observation group decreased significantly (P<0.05), and the serum HA level in the control group decreased significantly, with no significant difference in other indexes (P>0.05). After treatment, the serum HA, IV-C and PCIII in the observation group were significantly lower than those in the control group (P<0.05). The observation group's effect was significantly better than that of the control group, and the difference was statistically significant (P<0.05).Conclusion:Anti-virus and liver protection therapy can significantly improve the efficacy of patients combined TB with HBVI and alleviate liver damage, which is worthy of clinical recommendation.

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