替比夫定治疗HBV DNA和HBeAg阴性慢性乙型肝炎效果观察

The clinical efficacy of telbivudine in the treatment of patients with HBV DNA and HBeAg-negative chronic Hepatitis B

目的观察替比夫定治疗HBV DNA和HBeAg阴性慢性乙型肝炎效果。方法运用彩色多普勒超声仪检测53例HBV DNA和HBeAg阴性慢性乙型肝炎患者及42例未使用替比夫定治疗的HBV DNA和HBeAg阴性患者门静脉主干最大截面直径、平均流速、流量、肝静脉频谱及肝脏表面,同时检测肝纤维化指标及生化指标,并作HBsAg定量检测。结果替比夫定治疗组患者治疗后门静脉内径较治疗前减小(Dpv),门静脉血流速度增加(Vpv),血流量减少(Qpv)(P<0.01);肝静脉频谱、肝脏表面光滑度与对照组比较显著改善(P<0.01),HA、PⅢ、PALT、TBil及HBsAg含量显著降低(P<0.01)。结论替比夫定治疗HBV DNA和HBeAg阴性慢性乙型肝炎可显著改善患者的肝脏组织学及预后。

Objective To evaluate the clinical efficacy of telbivudine in the treatment of patients with HBV DNA and HBeAg-negative chronic hepatitis B.Methods Ninety-five patients with HBV DNA and HBeAg-negative chronic hepatitis B were randomly divided into 2 groups.The patients in the treatment group were orally given telbivudine 600 mg daily.Patients in the control group were given compound Salvia tablets.Additional Prolmon tablets would be given if biochemical markers were abnormal.Doppler sonography was used to investigate the diameter of the portal vein,the average velocity and flow of blood,changes in the hepatic vein Doppler waveform,and the surface of the liver.Additionally,the cirrhosis index and biochemical markers were evaluated and S antigen was determined quantitatively.Results In the treatment group,the diameter of the portal vein and bloodflow decreased significantly and the average velocity increased in comparison to the control group（P0.01）.The treatment group had much better improvement of the hepatic vein Doppler waveform,the surface of the liver,the cirrhosis index,biochemical markers,and quantitatively determined S antigen than did the control group（P0.01）.In the treatment group,outcome measures improved significantly（P0.01） compared to levels pretreatment.In the control group,outcome measures did not improve significantly（P0.05） compared to levels pretreatment.Conclusion Telbivudine significantly improved hepatic function for patients with HBV DNA and HBeAg-negative chronic hepatitis B.