核苷类药物在乙型肝炎后肝硬化治疗中的应用与疗效

Application and Curative Effect of Nucleoside Drugs in Treatment of Liver Cirrhosis After Hepatitis B

目的研究分析乙型肝炎后肝硬化患者接受核苷类抗病毒药物治疗的临床效果。方法选取2011年7月～2013年7月我院接收的163例失代偿期乙肝后肝硬化患者进行分析,将患者分组为A、B、C三组,A组使用拉米夫定（LAM）治疗、B组使用阿德福韦酯（ADV）治疗、C组使用恩替卡韦（ETV）治疗,对三组患者治疗12个月后的血清生化指标和病毒载量情况进行对比分析。结果三组患者的乙型肝炎病毒（HBV）DNA载量、ALT指标、Child-Pugh评分等均有较大幅度的降低,治疗前后据有统计学差异性,C组患者的病毒DNA载量和HBe Ag转阴率要比A组和B组优秀,结果存在统计学差异性。结论乙型肝炎后肝硬化患者接受核苷类抗病毒药物后,其体内的HBV病毒DNA载量有所下降,患者的HBe Ag转阴率有所提升,临床中未出现严重不良反应情况,使用恩替卡韦的治疗效果好。

Objective To study the clinical effect of hepatitis B cirrhosis patients receiving antiviral nucleoside therapy. Methods Selected 163 cases of decompensated liver cirrhosis from July 2011 to 2013 July in our hospital were analyzed, which were divided into group A, group B, group C, the group A used lamivudine（LAM） to treatment, the group B used adefovir dipivoxil（ADV） therapy, the group C treatment with entecavir（ETV）, on three groups of patients in the treatment of 12 months after the serum biochemical indexes and viral load. Results Three groups of patients with hepatitis B virus（HBV） DNA load, alt, child Pugh score were greatly reduced, before and after the treatment has significant difference, and patients in group C of the viral DNA load and HBe Ag seroconversion rate better than group A and group B, the results of the statistical differences. Conclusion After hepatitis B cirrhosis patients accepted nucleoside antiviral drugs, in the HBV DNA load decreased, in patients with HBe Ag negative conversion rate has improved. No serious adverse reactions in clinical, use entecavir entecavir treatment effect are good.