慢性重型乙型肝炎抗病毒治疗的生存分析

The survival analysis of chronic severe hepatitis B with antivirus treatment

目的研究抗病毒治疗对慢性重型乙型肝炎生存期的影响。方法选择121例HBVDNA阳性慢性重型乙型肝炎患者，分为恩替卡韦（ETV）治疗组42例、拉米夫定（LVD）治疗组34例和对照组45例，记录其原始资料并进行随访。采用Kaplain—Maier方法描绘生存曲线。采用Logrank检验比较各组的生存率。结果ETV组、LVD组和对照组的基线特征相似。随访结束时，ETV组、I。VD组和对照组的平均生存时间分别为（49．4±5．8）周、（51.6±6．7）周和（32．8±5．7）周，总体生存率分别为O．567、0．557和0．318。ETV组、LVD组与对照组比较，差异有统计学意义（χ^2值分别为5．742、5．472，P〈0．05）。ETV组与LVD组第2、4、8、12、24、48周生存率比较，差异均无统计学意义。结论ETV和LVD均可提高慢性重型乙型肝炎生存率，ETV与LVD对生存率的影响无差异。

Objective To analyse the effect of antivirus treatment on the survival time of chronic severe hepatitis B retrospectively. Methods one hundred and twenty-one patients with chronic severe hepatitis B and positive HBV DNA were divided into 3 groups： 42 patients in entecavir （ETV） group, 34 patients in lamivudine （LVD） group and 45 patients in control group. The primary data were recorded and followed. The survival curve was described using Kaplain-Maier method. The comparison of survival rate among groups was done using Logrank test. Results The baseline characteristics were well balanced among 3 groups. When the follow-up ended, the mean survival time of ETV group, LVD group and control group was （49.4±5.8） weeks, （51.6±6.7） weeks, （32.8±5.7） weeks; the total survival rate was 0. 567, 0. 557, 0. 318 respectively, there was a statistical difference between ETV group and control group （χ^2 = 5. 742, P〈0. 05）, or between LVD group and control group （χ^2 = 5. 472, P〈0.05）. There was not statistical difference between ETV group and LVD group in the week of 2,4,8,12,24,48. Conclusion ETV and LVD can improve the survival rate of chronic severe hepatitis B, and ETV is not different from LVD.