【摘要】 目的观察恩替卡韦(ETV)治疗失代偿期乙型肝炎肝硬化的疗效。方法 68例失代偿期乙型肝炎肝硬化患者随机分成2组:对照组32例采用常规保肝对症治疗,治疗组36例在常规治疗基础上给予口服ETV 0.5 mg/d,2组疗程均为52周。以治疗12,24,52周的病毒学、血清学、肝功能、凝血酶原活动度(PTA)、肝纤维化指标、Child-Pugh积分作为观察指标。结果治疗组HBV DNA拷贝数下降值、阴转率显著高于对照组,有显著性差异(P均<0.01)。在24和52周治疗组患者血清HBeAg阴转率及HBeAg/抗-HBe血清学转换率与对照组比较有显著性差异(p均<0.01)。治疗组在24周时肝功能、PTA好转及Child-Pugh积分下降,2组比较有显著性差异(P均<0.05);在52周时肝纤维化指标均显著改善,且2组比较有显著性差异(P均<0.05)。结论 ETV能快速、有效抑制HBV病毒复制,改善失代偿期乙型肝炎肝硬化患者的肝功能、PTA、肝纤维化指标及Child-Pugh积分等。更多还原

【Abstract】 Objective It is to observe the therapeutic effects of entecavir on decompensated cirrhosis caused by HBV.Methods Sixty-eight patients with liver cirrhosis caused by HBV were randomly divided into two groups:treatment group(n =36) and control group(n =32).The control group received the conventional liver protecting treatment.Besides the protecting treatment,the treatment group received the treatment of entecavir(0.5 mg/d).Both the treatment courses lasted for fifty-two weeks.In 12,24,52 weeks after treatment,the virological copies,biochemical parameters,PTA,hepatic fibrosis index and Child- Pugh scores were observed.Results The copies of HBV- DNA in treatment group were significantly decreased than that of the control group.The negative ratio of HBV- DNA(< 100 copies/ml) in treatment group was significantly higher than that in control group(P < 0.05).After 24 and 52 weeks’ treatments,the negative ratios of HBeAg and the ratios of HBeAg/anti-HBe sero-conversion in treatment group were significantly higher than those in control group(P < 0.05).ALT,AST,TBil,hepatic fibrosis index and Child- Pugh scores were significantly improved in treatment group at 24week time-point(P <0.05).After 52 week’ s treatment,the indexes of hepatic fibrosis were all improved in both groups,and compared with each other,the differences were significant(P <0.05).Conclusion Entecavir can rapidly and effectively inhibit the replication of HBV- DNA and improve hepatic function,hepatic fibrosis index and Child- Pugh scores in patients with liver cirrhosis at decompensated stage caused by HBV.更多还原