恩替卡韦与拉米夫定抗病毒治疗重型乙型肝炎临床对照研究

Comparison of Entecavir and Lamivudine Antiviral Therapy in Treating Severe Hepatitis B

目的探讨恩替卡韦治疗重型乙型肝炎对炎症因子及血管内皮功能的影响。方法选择乙型肝炎患者80例,随机分为观察组与对照组,各40例,观察组患者给予恩替卡韦,对照组患者给予拉米夫定。比较两组治疗前后肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6及血管内皮生长因子(VEGF)水平,以及治疗1个月两组血管通透性改变后的临床症状。结果治疗后,观察组TNF-α及IL-6水平低于治疗前(P<0.05),且低于对照组治疗后(P<0.05);观察组VEGF水平低于治疗前(P<0.05),且低于对照组治疗后(P<0.05);观察组存在腹腔积液、门脉高压及低蛋白血症的比例低于对照组(P<0.05)。结论恩替卡韦治疗重型乙型肝炎能有效抑制乙肝病毒复制,减轻肝细胞炎性反应,改善血管内皮细胞功能,尤其针对低蛋白血症、腹腔积液及门脉高压效果理想。

Objective To investigate the influence of entecavir for inflammatory and vascular endothelium cytokines with severe hepatitis B. Methods 80 cases were divided into two groups,40 cases in each group.The observation group used antiviral therapy with entecavir,and the control group used lamivudine.The TNF-α,IL-6 and VEGF levels before and after treatment and vascular permeability changes after 1 month were compared.Results After treatment,the TNF-α and IL-6 levels in the observation group were lower than before treatment（P〈0.05）,and were lower than control group after treatment（P〈0.05）;VEGF level in the observation group were lower than before treatment and the control group after treatment（P〈0.05）;the presence of ascites,portal hypertension and hypoalbu-minemia in the observation group were less than control group（P〈0.05）.Conclusion Eentecavir for inflammatory and vascular en-dothelium cytokines with severe hepatitis B can effectively inhibit the replication of hepatitis B virus and reduce the liver cell inflam-mation,can improve endothelial cell function,especially for hypoalbuminemia,ascites and portal hypertension.