恩替卡韦治疗失代偿期乙型肝炎肝硬化48周疗效观察

CURATIVE EFFECT OF ENTECAVIR TREATMENT FOR DECOMPENSATED CIRRHOSIS RESULTING FROM CHRONIC HEPATITIS B(48 WEEKS REPORT)

目的观察恩替卡韦治疗失代偿期乙型肝炎肝硬化的病毒学应答及临床效果。方法将54例失代偿期乙型肝炎肝硬化随机分为二组,对照组根据病情需要嘱其休息、合理饮食、保肝退黄、血浆、蛋白支持、利尿、抗感染等内科综合治疗。治疗组在此基础上加服恩替卡韦0.5mg,1次/d,观察24周、48周疗效。结果治疗组1例死亡,26例存活,生存患者肝功能指标明显改善,对照组5例死亡,22例存活,生存患者肝功能指标无明显改善。治疗24周、48周时,治疗组HBV-DNA分别为(3.2±0.9)lg拷贝/ml、(2.3±0.7)lg拷贝/ml明显低于对照组的(4.7±0.8)lg拷贝/ml、(4.5±0.7)lg拷贝/ml(P<0.05)。结论恩替卡韦能迅速有效地改善绝大多数失代偿期乙型肝炎肝硬化患者的生活质量,明显降低病死率,提高生存期。恩替卡韦治疗失代偿期乙型肝炎肝硬化患者有较好病毒学应答和肝功能改善。

Objective To observe the virologic response of entecavir in treatment of decompensated hepatitis B cirrhosis and its clinical effects. Methods Totally 54 cases of decompensated liver cirrhosis of hepatitis B were randomly divided into two groups. The control group according to the condition re- ceived a comprehensive therapy included rest, reasonable diet, liver protection and removing jaundice, plasma and protein support, diuresis, anti- infection, the treatment group received oral entecavir 0. 5rag, QD based on the comprehensive treatment, and then the curative effect was observed for 24 weeks and 48 weeks. Results There were 26 cases of survival and 1 case death in the treatment group,the liver function indexes of survival patients were obvious improvement. But in the control group, 5 cases of died and 22 cases survived, and all survival patients showed no significant improvement with liver function indexes. Posttreatment for 24 weeks and 48 weeks, the HBVDNA in treatment group were （3.2 ± 0.9） LG copies/ml, （2.3 ± 0.7） LG copies/ml was significantly lower than that of con- trol group （ 4.7 ± 0.8） LG copies/ml, （4.5 ± 0.7） LG copies/ml（P〈0.05 ）. Conelusion Entecavir can rapidly and effectively improve the quality of life of most of decompensated hepatitis B liver cirrho- sis patients, significantly reduce the mortality rate, improve the survival time, and have a better viro- logic response and improvement of liver function.