核苷（酸）类抗病毒药物对失代偿期乙肝肝硬化患者肝脏指标及预后的改善效果

Effects of nucleoside （acid） antiviral drugs on improvement of liver indexes and prognosis of patients with decompensated hepatitis B cirrhosis

目的观察核苷（酸）类抗病毒药物对失代偿期乙肝肝硬化患者肝脏指标及预后的改善效果。 方法选取2010年1月至2011年1月68例失代偿期的乙肝肝硬化患者为研究对象，将患者随机分为观察组与对照组，每组34例。对照组给予常规治疗，观察组在对照组基础上行核苷（酸）类抗病毒药物干预，检测两组丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、白蛋白（ALB）、胆碱酯酶（CHE）、凝血酶原时间（PT）、Child-Pugh评分及HBV DNA载量，并比较两组预后的改善效果。 结果观察组ALT、TBIL、ALB、CHE、PT含量及Child-Pugh评分均优于对照组，差异有统计学意义（P〈0.05）；观察组HBV DNA载量[（1.89±1.23）log10拷贝/ml]低于对照组[（5.43±1.12）log10拷贝/ml]，差异有统计学意义（P〈0.05）。观察组未发生肝癌，对照组肝癌发生率为35.29%，差异有统计学意义（P〈0.05）。 结论核苷（酸）类抗病毒药物治疗失代偿期乙肝肝硬化可有效抑制HBV DNA的复制，减轻肝脏炎症程度，降低肝癌发生率，从而有效改善患者肝功能及预后。

Objective To observe the effects of nucleoside （acid） antiviral drugs on the im- provement of liver indexes and prognosis of patients with decompensated hepatitis B cirrhosis. Methods Sixty-eight patients with decompensated hepatitis B cirrhosis who were treated from January 2010 to January 2011 were selected as the study subjects. The patients were randomly divided into the observation group and the control group, with 34 cases in each group. The control group was given rou- tine treatment. The observation group was given nucleoside （acid） antiviral drug intervention in addition. The serum alanine aminotransferase （ ALT ）, total bilirubin （ TBIL ）, albumin （ ALB ）, cholinesterase （CHE）, prothrombin time（PT）, Child-Pugh score and DNA HBV load of the two groups were detected. The improvement effects were compared between the two groups. Results ALT, TBIL, ALB, CHE, PT and Child-Pugh score in the observation group were better than those in the control group （ P 〈 0. 05 ） ; DNA HBV load of the observation group [ （ 1.89±1.23 ） logl0 copy/ml~ was lower than that of the con- trol group [ （5.43±1.12） log10 copy/inl] （P 〈0. 05）. In the observation group, there was no patient with liver cancer, while the incidence rate of liver cancer in the control group was 35.29% （P 〈0. 05）. Conclusions Nucleoside （acid） antiviral drugs can inhibit the replication of DNA HBV, reduce the degree of liver inflammation and the incidence of liver cancer, so as to effectively improve the liver function and prognosis of patients with decompensated hepatitis B cirrhosis.