【摘要】 目的观察恩替卡韦治疗失代偿期慢性乙型病毒性肝炎(CHB)肝硬化的近远期疗效。方法失代偿期CHB肝硬化患者95例,随机分为观察组(n=47)和对照组(n=48)。对照组常规治疗,观察组在对照组基础上加用恩替卡韦胶囊口服,2组均连续治疗1年。结果治疗4、12、24及48周时,2组HBV DNA载量、丙氨酸氨基转移酶(ALT)及总胆红素(TBil)含量均持续下降(P<0.05或P<0.01),且观察组显著低于对照组(P<0.05或P<0.01);治疗24及48周时,观察组血清白蛋白(ALB)含量显著升高(P<0.01),且高于对照组(P<0.01);治疗48周时,观察组伴腹水患者比例低于对照组,ChildPugh分级情况优于对照组(P<0.05或P<0.01);2组乙型肝炎e抗原(HBe Ag)血清学转换率无显著差异(P>0.05)。结论恩替卡韦可有效降低失代偿期CHB肝硬化患者HBV DNA载量,改善肝功能,促进病情逆转。更多还原

【Abstract】 Objective To explore the short- term and long- term efficacy of entecavir in treatment of patients with decompensated hepatitis B virus( HBV) liver cirrhosis. Methods A total of 95 patients with decompensated HBV cirrhosis were randomly divided into observation group( n =47) and control group( n = 48). The control group was treated with conventional treatment,and the observation group was treated with oral entecavir capsule on the basis of the control group. Both groups were treated for one year. Results At the 4th,12 th,24thand 48 thweeks of treatment,the levels of HBV DNA,alanine aminotransferase( ALT) and total bilirubin( TBil) in both groups decreased continuously( P < 0. 05 or P < 0. 01),and these indexes of observation group were significantly lower than control group( P < 0. 05 or P < 0. 01). At the 24 thand 48thweeks of treatment,the ALB level of observation group increased significantly( P < 0. 01),and was significantly higher than control group( P < 0. 01). At the 48 thweek of treatment,the proportion of patients with ascites in observation group was significantly lower than control group,and the Child- Pugh classification was better than control group( P < 0. 05 or P < 0. 01). The Hepatitis B e antigen( HBe Ag) serological conversion rate showed no significant difference between two groups( P > 0. 05). Conclusion Entecavir can effectively decrease the HBV DNA level and improve the liver function as well as promote disease reversal in patients with decompensated HBV liver cirrhosis.更多还原