恩替卡韦治疗慢性乙型重型肝炎的近期疗效观察

The short-term clinical effect of entecavir in the treatment of patients with chronic severe viral hepatitis B

目的评价恩替卡韦治疗慢性乙型重型肝炎的近期临床疗效。方法57例患者在常规治疗的基础上给予恩替卡韦0.5mg,每日1次口服;另86例给予拉米夫定100mg,每日1次口服,存活患者的治疗时间不少于6个月。结果接受恩替卡韦治疗后6个月时,总胆红素和谷丙转氨酶分别由治疗前的270.1±81.8μmol/L和342.5±130.7U/L降至74.9±36.5μmol/L和71.24±2.8U/L,均较拉米夫定组改善更明显(P<0.05);恩替卡韦组的HBVDNA转阴率为69.8%,明显高于拉米夫定组的46.8%(P<0.05)。病死率分别为7.0%和10.5%,无显著性差异(P>0.05)。结论恩替卡韦治疗慢性乙型重型肝炎患者在近期临床疗效、肝功能改善和抑制病毒复制方面均优于拉米夫定治疗者。

Objective To evaluate the short-term effect of entecavir （ETV） in the treatment for patients with chronic severe hepatitis B. Methods Fifty-seven patients with chronic severe hepatitis B were treated with enteeavir at dose of 0.5 mg daily besides conventional therapy for at least 6 months,while 86 patients were treated with lamivudine （LVD） 100 mg as the control group. Results The average levels of TBIL and ALT decreased from 270.1±81.8μmol/L and 342.5±130.7U/L before therapy to 74.9±36.5μmol/L and 71.2±42.8U/L after therapy in entecavir group,which were more obvious than in lamivudine group （P〈0.01）. The loss of HBV DNA in enteeavir group （69.8%） was higher than in lamivudine group（46.8%,P〈0.05）. There was no significant difference in death rates between the two groups（7.0% versus 10.5%,P〉0.05）. Conclusioins The better short-term clinical efficacy in patients with chronic severe hepatitis B treated with entecavir is found as compared with lamivudine.