乙肝肝硬化肝功能失代偿期不规范停用恩替卡韦复发后再次恩替卡韦治疗的效果

The efficacy of entecavir retreatment in decompensated hepatitis B cirrhotic patients with irregular discontinuation of entecavir

目的探讨乙肝肝硬化肝功能失代偿期患者不规范停用恩替卡韦复发后再次恩替卡韦治疗的临床效果。方法选取2013年4月至2015年4月我院诊治的乙肝肝硬化肝功能失代偿期80例不规范停用恩替卡韦复发再用恩替卡韦患者设为观察组,选择同期入院治疗的80例乙肝肝硬化肝功能失代偿期患者不规范停用恩替卡韦复发不用恩替卡韦治疗患者为对照组,比较两组疗效。结果两组患者6周和12周生化学复常率差异不显著(P>0.05);观察组2周生化学复常率显著低于对照组(P<0.05);观察组死亡率高于对照组(P<0.05);观察组治疗2周、6周以及12周HBV-DNA阴转率,显著高于对照组(P<0.05);观察组12周HBe Ag血清学转换率及HBs Ag滴度较入院时下降50%的比例,显著高于对照组(P<0.05);观察组不良反应发生率为5.0%,显著低于对照组的16.25%(P<0.05)。结论乙肝肝硬化功能失代偿期患者不规范停用恩替卡韦复发后再次恩替卡韦治疗抗病毒疗效显著,安全性较高,值得推广使用。

Objective To investigate the efficacy of entecavir retreatment in decompensated hepatitis B cirrhotic patients with irregular discontinuation of entecavir. Methods From Apirl 2013 to April 2015, 160 decompensated hepatitis B cirrhotic patients with recurrence due to irregular discontinuation of entecavir were assigned randomly into observation group and control group. The patients in observation group received con- ventional therapy plus entecavir,while the patients in control grpup received conventional therapy only. Results The biochemical recovery rate in the 6th and 12th week vkas not significantly different between two groups （P 〉 0.05）; the biochemical recovery rate in observation group at the 2nd week was significantly lower than in control group （P 〈 0.05）. The mortality rate in observation group was higher than in control group （P 〈 0.05）. HBV-DNA negative conversion rate in observation group at the 2nd, 6th, and 12th week was significantly higher than control group （P 〈 0.05）. At the 12th week, the rate of HBeAg seroconversion and the ratio of HBsAg titer decreased by 50% compared with admission in observation group was significantly higher than control group （P 〈 0.05）. The incidence of adverse reactions in the observation group was 5% which was significantly lower than 16.25% in the control group （P 〈 0.05）. Conclusion Decompensated hepatitis B cirrhotic patients who discontinued entecavir irregularly and resulted in recurrence benefit from retreatment of entecavir.