恩替卡韦治疗慢性乙型重型肝炎49例疗效观察

Curative effects of Entecavir in 49 chronic severe hepatitis B

目的:观察恩替卡韦治疗慢性重型乙型肝炎12周的疗效。方法:治疗组49例,使用恩替卡韦口服,每日0.5mg,同时使用常规的慢性乙型重型肝炎治疗方案。对照组47例仅使用常规的慢性乙型重型肝炎治疗方案。治疗前、治疗期间每两周及治疗结束时,分别检测HBVDNA、TBIL、谷丙转氨酶(ALT)、总胆红素、凝血酶原活动度、腹部彩超、无创瞬时弹性检测等,共观察12周。结果:治疗组血清HBVDNA的下降水平明显好于对照组(P<0.01),血清HBVDNA阴转率为83.67%,而对照组仅为8.51%。治疗组ALT、TBIL下降水平、凝血酶原活动度升高水平均明显好于对照组(P<0.01)。治疗组病死率2.04%,对照组8.51%,治疗组发展为坏死后肝硬化的几率为2.08%,而对照组有34.88%的患者发展为坏死后肝硬化。结论:应用恩替卡韦治疗慢性乙型重型肝炎疗效明显好于常规治疗,可以降低乙型重型肝炎的病死率及发展为肝硬化的几率。

Objective：To observe the curative effects of Entecavir（ETV） in chronic severe hepatitis B during 12 weeks.Methods：49 patients were divided into treatment group and were administered with ETV 0.5mg,po,qd combined with conventional treatment 47 patients were divided into control group and were treated with conventional program.HBVDNA,TBIL,ALT,TB,Pta,abdominal sonography,etc.were examined before treatment,per 2 weeks during treatment and after treatment.Results：Serum HBVDNA level decreased more significantly in the treatment group than thoese in the control group（P0.01）.Serum HBVDNA clearance ratio in the treatment group is 83.67%,yet corresponding index in the control group is only 8.51%.Index such as ALT,TB,Pta,etc.were ameliorated more significantly in the treatment group than thoese in the control group（P0.01）.The mortality in the treatment group and the control group was 2.04% and 8.51% respectively.The incidence rate of postnecrotic cirrhosis in the treatment group and the control group was 2.08% and 34.88% respectively.Conclusion：The curative effects of ETV in chronic severe hepatitis B is superior to conventional program,it can decrese the corresponding mortality and incidence rate of postnecrotic cirrhosis in chronic severe hepatitis B.