替比夫定治疗失代偿期乙肝肝硬化30例临床观察

The Effect of Telbivudine on Patients with Decompensated Cirrhosis Due to Hepatitis B

目的：观察失代偿期乙型肝炎肝硬化患者应用替比夫定（Telbivud ine LDT）治疗的临床效果和安全性。方法：30例患者随机分成治疗组（17例）和对照组（13例）。治疗组在常规治疗同时服用替比夫定,每日600 mg,对照组给予常规治疗。结果：替比夫定治疗组观察24个月。所有患者治疗3-6月后症状和体征逐渐改善,腹水消失。替比夫定治疗组1年内血清HBV-DNA转阴率94.1%（16/17）,血清白蛋白和凝血酶原活动度（PTA）上升、总胆红素均有下降,Child-Pugh评分减少,2年生存率达94.1%,并发症及再次住院率明显下降。结论：替比夫定治疗能改善失代偿期乙肝肝硬化肝功能和提高生存率。

Objective： To evaluate the- efficacy and safety of Telbivudine in treating decompensated cirrhosis due to chronic hepatitis B. Method： Thirty patients with decompensated cirrhosis of hepatitis B virus infection were randomly divided treatment group（ 17 cases） and control group（ 13 cases）, which were matched for age, gender, liver function and Child - Pugh score. Treatment group were treated with Telbivudine 600 mg orally once daily. Supportive treatment and symptomatic treatment were given in two groups. Result： The median follow - up was 24 months for the patients in treatment group. Symptoms of all patients were relieved gradually after 3 to 6 months. Ascites disappeared in all patients. The rates of negative conversion for the serum HBV - DNA was 94.1% in the patients of treatment group after 3 months of Telbivudine therapy. There was a significant improvement in clinical symptoms and liver function, with an increase in serum albumin and PTA, and a decrease in total serum bilirubin and child - pugh score. Two years survival rate was 94.1% （ 16/17）. The complication rate and the readmission rate were also markedly reduced. Conclusion： Telbivudine therapy can result in a significant improvement of liver function and the prolonging of survival time in patients with decompensated HBV cirrhosis.