【摘要】 目的探索主动随访督导管理模式干预乙型肝炎肝硬化患者长期依从抗病毒治疗的效果。方法回顾分析我院32例乙型肝炎肝硬化代偿期患者,在每个月主动随访督导2次的管理模式干预下长期用恩替卡韦抗病毒治疗的依从性,治疗后乙型肝炎病毒标志物变化情况,肝组织炎症分级及纤维化分期。结果在主动随访中发现,有34.38%患者有中断抗病毒治疗念头,经过督导教育全都能够继续坚持治疗;经过(31.75±28.28)周治疗,所有患者HBV-DNA低于检测线下限,HBeAg阳性的患者发生转换率为45.45%;经过(305.00±147.36)周治疗后,肝组织炎症评分均值由(3.88±0.33)分降至(2.28±0.68)分,肝组织纤维化评分均值由(4.00±0.00)分降至(2.13±0.79)分,统计学意义显著(P<0.01);肝组织炎症与纤维化评分呈现降级改变率分别为96.88%、93.75%。结论通过主动随访督导管理模式干预,乙型肝炎肝硬化患者能良好地长期依从抗病毒治疗,有助于长期持续抑制HBV-DNA复制,致使肝脏组织的炎症及纤维化获得减轻。更多还原

【Abstract】 Objective To explore the effect of active follow-up supervision and management mode on long-term adherence to antiviral therapy in patients with hepatitis B cirrhosis. Methods A retrospective analysis of 32 patients with hepatitis B cirrhosis in our hospital, the long-term follow-up of entecavir antiviral treatment under the intervention of two consecutive management modes of monitoring, the change of hepatitis B virus markers after treatment Situation, liver tissue inflammation grade and fibrosis stage. Results In the active follow-up, 34.38% of the patients had the idea of interrupting antiviral therapy. After supervised education, they were able to continue treatment. After(31.75 ±28.28) weeks of treatment, all patients had lower HBV-DNA than the lower limit of detection line, HBeAg-positive The conversion rate of patients was 45.45%; after(305.00 ±147.36) weeks of treatment, the mean score of liver tissue inflammation score decreased from(3.88±0.33) to(2.28±0.68), and the mean liver fibrosis score was(4.00±0.00). The score was reduced to(2.13±0.79) points,the statistical significance was significant(P<0.01); the liver tissue inflammation and fibrosis scores showed a degraded rate of change of 96.88% and 93.75%, respectively. Conclusion Through active follow-up supervision and management mode intervention, patients with hepatitis B cirrhosis can long-term adherence to antiviral therapy, which can help to inhibit HBV-DNA replication for a long time, resulting in the reduction of inflammation and fibrosis of liver tissue.更多还原