恩替卡韦对慢性重症乙型肝炎的治疗意义

Therapeutic effect of entecavir on chronic severe hepatitis B

目的研究恩替卡韦对慢性重症乙型肝炎的治疗意义。方法选择66例慢性重症乙型肝炎患者随机分为2组,对照组33例患者采用综合治疗,观察组33例患者在对照组综合治疗基础上给予恩替卡韦治疗,治疗结束后对2组肝功能指标、乙型肝炎指标进行检测,评价2组治疗效果。结果观察组显效17例,有效14例,总有效率为93.94%;对照组显效7例,有效13例,总有效率60.61%;观察组治疗效果明显好于对照组,2组比较差异有统计学意义(P<0.05)。2组治疗后丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、血清总胆红素(TB)、凝血酶原时间(PT)、天冬氨酸氨基转移酶(AST)各指标均较治疗前好转,观察组TB下降幅度明显大于对照组,差异具有统计学意义(P<0.05)。观察组治疗2周、4周HBVDNA呈明显下降趋势,对照组治疗后与治疗前差异不明显,观察组与对照组比较差异有统计学意义(P<0.05)。结论恩替卡韦抗病毒作用强大,起效快,可迅速降低患者血清HBVDNA水平,改善患者肝脏功能,对提高慢性重症乙型肝炎患者的预后具有积极的意义。

Objective To observe the therapeutic effect of entecavir on chronic severe hepatitis B. Methods 66 patients with chronic severe hepatitis B were randomly divided into two groups, the 33 patients in control group were treated by combined modality therapy, however, the other 33 patients in observation group, on the basis of control group, were treated by entecavir. After treatment the parameters of liver function and hepatitis B were detected, and the therapeutic effect was compared between two groups. Results The total effective rate in observation group was 93.94%, with obvious efficiency 17 cases and efficiency 14 cases, in contrast to that, the total effective rate in control group was 60.61% , with obvious efficiency 7 cases and efficiency 13 cases, the therapeutic effect in observation group was superior to that in control group, and there was a significant difference between two groups （ P 〈 0.05 ）. After treatment the parameters including ALT, ALB,TB, PT, AST were obviously improved,as compared with those before treatment. The decrease extent of TB in observation group was significantly greater than that in control group （ P 〈 0. 05 ）. The HBV DNA in observation group showed a obvious downtrend 2 weeks ,4 weeks after treatment, however,the downtrend in control group was not obvious after treatment, and there was a significant difference between observation group and control group （ P 〈 0.05 ）. Conclusion The antiviral action of entecavir is powerful, with fast effect, which can rapidly reduce patient＇ s serum HBV DNA levels, improve patient＇s liver function,which has a positive significance to improve the prognosis of patients with chronic severe hepatitis B.