失代偿期乙型肝炎肝硬化治疗中替比夫定的应用效果及安全性分析

Analysis of application effect and safety of telbivudine in the treatment of decompensated period of hepatitis B virus related liver cirrhosis

目的分析失代偿期乙型肝炎肝硬化治疗中替比夫定的应用效果及安全性。方法 94例失代偿期乙型肝炎肝硬化患者,采用随机字母表法分为观察组与对照组,各47例。对照组患者采用常规治疗,观察组患者在常规治疗基础上采用替比夫定治疗。对比两组患者肝功能指标、病毒学指标转阴情况、生存率及不良反应情况。结果治疗前,两组患者的血清总胆红素(TBIL)、白蛋白(ALB)、丙氨酸转氨酶(ALT)比较,差异均无统计学意义(P>0.05);治疗后均较治疗前改善,且观察组改善程度优于对照组,差异均具有统计学意义(P<0.05)。观察组患者中有3例乙型肝炎e抗原(HBe Ag)阴转,有6例HBe Ag/乙型肝炎e抗体(HBe Ab)血清转换;7例死亡,生存40例,生存率为85.11%;对照组患者中无病情好转症状;16例死亡,生存31例,生存率为65.96%;观察组患者生存率明显高于对照组,差异具有统计学意义(χ~2=4.663,P<0.05)。观察组患者不良反应发生率17.02%与对照组10.64%对比,差异无统计学意义(P>0.05)。结论失代偿期乙型肝炎肝硬化治疗中应用替比夫定可明显改善肝功能,缓解病情,提高生存率,且未明显增加不良反应。

Objective To analyze the aapplication effect and safety of telbivudine in the treatment of decompensated period of hepatitis B virus related liver cirrhosis. Methods A total of 94 patients with decompensated period of hepatitis B virus related liver cirrhosis were divided by random alphabet method into observation group and control group, with 47 cases in each group. The control group received conventional therapy, and the observation group also received telbivudine for treatment. Comparison were made on liver function index, negative conversion of virology index, survival rate and adverse reactions situation in two groups. Results Before treatment, both groups had no statistically significant difference in serum total bilirubin（TBIL）, albumin（ALB） and alanine aminotransferase（ALT）（P〉0.05）. After treatment, both groups had improvement than before treatment, and the observation group had better improvement degree than the control group. Their difference had statistical significance（P〈0.05）. The observation group had 3 chronic hepatitis B e antigen（HBe Ag） negative conversion cases, 6 HBe Ag/Hepatitis B virus e Antigen A b（HBe Ab） seroconversion cases, 7 death cases and 40 survival cases, with survival rate as 85.11%. The control group had no improved symptoms, 16 death cases and 31 survival cases, with survival rate as 65.96%. The observation group had obviously higher survival rate than the control group, and the difference had statistical significance（χ-2=4.663, P〈0.05）. The observation group had no statistically significant difference in incidence of adverse reactions as 17.02%, comparing with 10.64% in the control group（P〉0.05）. Conclusion Application of telbivudine in treating decompensated period of hepatitis B virus related liver cirrhosis can obviously improve liver function, relieve illness, and improve survival rate without significantly increasing adverse reactions.