恩替卡韦治疗慢性重症乙型肝炎的临床疗效观察

CLINICAL OBSERVATION OF EFFECT OF ENTECAVIR ON TREATING CHRONIC SEVERE HEPATITIS B

目的:观察恩替卡韦(ETV)对慢性重症乙型肝炎临床疗效的影响,并比较慢性重症乙型肝炎早、中、晚期的疗效。方法:将我院2009年1月至2010年6月期间收治的251例慢性重症乙型肝炎早、中、晚期患者按同期随机分为治疗组和对照组。对照组采用综合内科治疗,治疗组在此基础上加用恩替卡韦。定期观察肝功能、凝血酶原时间(PT)、HBV DNA载量及患者的治愈、好转率。结果:治疗组在血清生化学、HBV DNA载量、临床综合疗效方面效果明显优于对照组,能显著提高总有效率,特别是早期给药更显著降低HBV DNA载量、降低病死率,差异均具有统计学意义(P﹤0.05)。结论:恩替卡韦能有效提高重型肝炎治疗有效率,降低病死率,其疗效与抑制病毒复制有关,临床上应早期使用疗效更佳。

Objective：To study the curative effect of Entecavir（ETV） in treating severe hepatitis B and compare its curative effect on patients of different stages.Methods：251 cases with severe hepatitis B were admitted to our hospital from January 2009 to June 2010.According to diagnostic criteria,patients were divided into early,middle and late stages.Meanwhile,the same stage patients were randomly divided into treatment and control group.Common treatment was used in the control group.Besides common treatment,Entecavir was given to treatment group.TB,ALT,AST,ALB and PT,serum markers of hepatitis B（HBsAg,HBsAb,HBeAg,HBeAb and HBcAb）,and serum HBV DNA by PCR assay were measured.Statistic analyses between two groups in the clinical cure rate and improvement were made.Results：The total curative effect of treatment group was better than that of the control group,especially in reducing mortality and HBV-DNA level（P﹤0.05）.Conclusion：ETV can significantly increase the curative efficiency and reduce the mortality of severe hepatitis B.For treatment of severe hepatitis B,the therapeutic effect of ETV is related with inhibiting viral replication,and should be used earlier.