【摘要】 目的：探究艾米替诺福韦联合双环醇治疗乙型肝炎e抗原（HBeAg）阳性慢性乙型肝炎（CHB）合并脂肪肝的效果。方法：选取2024年1—12月江门市新会区人民医院收治的HBeAg阳性CHB合并脂肪肝患者60例，采用随机数字表法分为对照组（30例，口服艾米替诺福韦）和观察组（30例，口服艾米替诺福韦联合双环醇）。对比两组临床疗效。结果：观察组乙型肝炎病毒-DNA转阴率高于对照组（P=0.037）；治疗后，观察组肝硬度小于对照组（P=0.004）；治疗后，观察组丙氨酸氨基转移酶、天冬氨酸氨基转移酶水平比对照组低（P<0.05）；治疗后，两组乙型肝炎表面抗原、HBeAg水平比较，无统计学差异（P>0.05）；观察组治疗总有效率高于对照组（P=0.038）；两组不良反应总发生率比较，无统计学差异（P>0.05）。结论：艾米替诺福韦联合双环醇治疗HBeAg阳性CHB合并脂肪肝的效果显著，可促进乙型肝炎病毒-DNA转阴，改善肝硬度及肝功能指标，安全性较高，但对乙型肝炎表面抗原和HBeAg的抑制作用不明显。更多还原

【Abstract】 Objective: To explore the effect of tenofovir amibufenamide combined with bicyclol in the treatment of hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB) complicated with fatty liver. Methods: A total of 60 HBeAg-positive CHB patients complicated with fatty liver admitted to Xinhui People’s Hospital in Jiangmen City from January to December 2024 were selected and divided into control group(30 cases, oral tenofovir amibufenamide) and observation group(30 cases, oral tenofovir amibufenamide combined with bicyclol) according to the random number table method. The clinical efficacy of the two groups was compared. Results: The negative conversion rate of hepatitis B virus-DNA in the observation group was higher than that in the control group(P=0.037). After treatment, the liver stiffness in the observation group was lower than that in the control group(P=0.004). After treatment, the levels of alanine aminotransferase and aspartate aminotransferase in the observation group were lower than those in the control group(P<0.05). After treatment, there were no statistically significant differences in the levels of hepatitis B surface antigen and HBeAg between the two groups(P>0.05). The overall response rate of treatment in the observation group was higher than that in the control group(P=0.038). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion: Tenofovir amibufenamide combined with bicyclol has a significant effect in the treatment of HBeAg-positive CHB complicated with fatty liver, and can promote the negative conversion of hepatitis B virus-DNA, improve liver stiffness and liver function indexes, and achieve high safety. However, the inhibitory effect on hepatitis B surface antigen and HBeAg is not obvious.更多还原