【摘要】 目的观察失代偿期乙型肝炎肝硬化患者应用恩替卡韦抗病毒治疗24周时疗效和安全性。方法 80例失代偿期乙型肝炎肝硬化患者分为恩替卡韦组40例和对照组40例。观察两组患者血清HBV DNA的水平、ALT、TBiL、白蛋白(ALB)、凝血酶原活动度(PTA)、Child-Pugh积分和终末期肝脏病模型(MELD)评分的变化情况。结果治疗24周时,恩替卡韦组HBVDNA为(3.0±0.9)lg拷贝/mL明显低于对照组的(6.7±0.4)lg拷贝/mL(t=21.76,P<0.01);恩替卡韦组TBiL为(15.2±4.2)μmol/L明显低于对照组(35.3±7.4)μmol/L(t=14.89,P<0.01);恩替卡韦组ALB、PTA分别为(37.6±7.2)g/L、(79.2±10.5)%明显高于对照组的(34.4±5.5)g/L、(73.9±12.0)%(t分别为2.23、2.10,P<0.05);恩替卡韦组Child-pugh积分、MELD分值分别为(6.2±1.3)、(6.9±1.7)明显低于对照组(8.1±1.1)、(10.9±1.8)(t分别为6.78、9.77,P<0.01)。结论恩替卡韦能迅速降低HBVDNA水平,改善失代偿期乙型肝炎肝硬化患者肝功能。更多还原

【Abstract】 Objective To study the efficacy and safety of entecavir in patients with decompensated hepatitis B-induced cirrhosis on 24-week treatment.Methods Eighty patients with decompensated hepatitis B-induced cirrhosis were devided into entecavir group(n=40)and controlgroup(n=40)for 24 weeks.The changes of serum HBV DNA,ALT,total bilirubin(TBiL),prothrombin activity(PTA),albumin(ALB) levels,Child-Pugh scores and MELD scores of patients in two groups were investigated.Results After 24-week treatment,HBV DNA level [(3.0±0.9) lg copies/mL] of patients in entecavir group were significantly lower than that [(6.7±0.4) lg copies/mL] of patients in control group(t=21.76,P<0.01);TBiL level [(15.2±4.2)μmol/L] of patients in entecavir group were significantly lower than that [(35.3±7.4) μmol/L] of patients in control group(t=14.89,P<0.01);ALB level [(37.6±7.2) g/L] of patients in entecavir group were significantly higher than that [(34.4±5.5) g/L] of patients in control group(t=2.23,P<0.05);PTA level(79.2±10.5)% of patients in entecavir group were significantly higher than that(73.9±12.0)% of patients in control group(t=2.10,P<0.05).Child-Pugh score(6.2±1.3) of patients in entecavir group were significantly lower than that(8.1±1.1) of patients in control group(t=6.78,P<0.01).MELD score(6.9±1.7) of patients inentecavir group were significantly lower than that(10.9±1.8) of patients in control group(t=9.77,P<0.05).Conclusion Entecavir treatment causes a greater decrease in levels of HBV DNA and greater biochemical and clinical improvement as compared to control in patients with decompensated hepatitis B-induced cirrhosis.更多还原