恩替卡韦分散片治疗慢性乙型病毒性肝炎慢加急性肝衰竭的近期疗效

Evaluation of the short- term efficacy of China- made entecavir on acute- on- chronic hepatitis B liver failure

目的探讨恩替卡韦分散片治疗慢性乙型病毒性肝炎慢加急性肝衰竭的近期临床疗效。方法回顾性分析我院收治的98例慢性乙型病毒性肝炎慢加急性肝衰竭患者的临床资料,分成观察组和对照组,两组均给予常规内科综合治疗,56例应用恩替卡韦分散片抗病毒治疗者为观察组,42例应用恩替卡韦片抗病毒治疗者为对照组。比较两组患者治疗后12周乙肝病毒DNA、肝功能、凝血酶原时间和治疗12周后病死率的差异。结果两组患者乙肝病毒DNA水平快速下降,治疗第12周时,观察组中40例(71.43%)乙肝病毒DNA<500 IU/m L,对照组中31例(73.81%)乙肝病毒DNA<500 IU/m L,两组比较差异无统计学意义(2=0.068,P>0.05)。12周时,两组患者的丙氨酸转氨酶、天门氨酸转氨酶、总胆红素较治疗前显著下降,血清白蛋白明显提高,PT明显缩短,组间比较差异均无统计学意义(P>0.05)。至12周时,观察组病死率32.14%(18/56),对照组病死率30.95%(13/42),两组比较差异无统计学意义(P>0.05)。两组均无不良反应发生。结论恩替卡韦分散片治疗慢性乙型病毒性肝炎慢加急性肝衰竭时能取得较好的临床疗效,是一种快速、强效、安全的抗乙型肝炎病毒药物。

Objective To observe the short- term clinical effects of China- made entecavir antiviral therapy in patients with acute- on- chronic hepatitis B liver failure. Methods A total of 98 cases of hospitalized patients with acute- on- chronic hepatitis B liver failure were enrolled. They were divided into the observation group and the control group. On the basis of the routine comprehensive treatment,the observation group of 56 cases were given China- made entecavir and the control group of 42 cases received imported entecavir. We compared the mortality rates,the hepatitis B virus（ HBV） DNA,liver function,prothrombin time after twelve weeks of treatment between the two groups. Results The HBV DNA levels in two groups were falling rapidly. There was no significant difference between the two groups in the rate of patients with undetectable HBV DNA after 12 weeks treatment,71. 43%（ 40 /56） and 73. 81%（ 31 /42）（ 2=0. 068,P〈0. 05）. After 12 weeks of treatment,the alanine aminotransferase,aspartate aminotransferase and total bilirubin were reduced,while albumin was increased and prothrombin time was significantly shorter in the two groups. No significant differences were found between the observation group and the control group（ P〉0. 05）. The mortality rates of two groups were 32. 14%（ 18 /56） and 30. 95%（ 13 /42）,（ Х^2= 0. 016,P〈0. 05）. No adverse reactions were found in two groups. Conclusion The clinical efficacy and safety of China- made entecavir in the treatment of acute- on- chronic hepatitis B liver failure is good. China- made entecavir is a rapid,powerful and safe antiviral drug.