乙型肝炎肝硬化失代偿期患者抗病毒治疗效果分析与探讨

Analysis and discussion on the effect of antiviral therapy for patients with decompensated cirrhosis of hepatitis B

目的探讨与分析乙型肝炎肝硬化失代偿期患者进行抗病毒治疗的效果。方法 138例乙型肝炎肝硬化失代偿期患者,根据奇偶数分为对照组(偶数)和观察组(奇数),各69例。对照组患者采用常规治疗,观察组患者在对照组基础上增加抗病毒治疗。比较两组患者肝功能情况、病毒指标变化情况以及肝癌、死亡发生情况。结果观察组患者治疗后白蛋白(ALB)、总胆红素(TBIL)、谷丙转氨酶(ALT)水平均优于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗后乙型肝炎病毒脱氧核糖核酸(HBV DNA)转阴患者67例,占比97.10%;肝癌2例,占比2.90%;死亡1例,占比1.45%。对照组治疗后HBV DNA转阴患者26例,占比37.68%;肝癌9例,占比13.04%;死亡7例,占比10.14%。两组HBV DNA转阴率、肝癌发生率及死亡率比较差异具有统计学意义(P<0.05)。结论抗病毒治疗能够有效地改善乙型肝炎肝硬化失代偿期患者的临床症状,促进患者肝功能的恢复,并且对于HBV DNA的复制具有一定抑制作用,临床价值较高,值得推广使用。

Objective To investigate and analyze the effect of antiviral therapy for patients with decompensated cirrhosis of hepatitis B. Methods A total of 138 patients with decompensated cirrhosis of hepatitis B were divided into control group （even number） and observation group （odd number） according to odd or even numbers, 69 cases in each group. Patients in the control group were treated with conventional therapy, patients in the observation group were treated with antiviral therapy on the basis of the control group. The liver function, the changes of viral indicators and the incidence of hepatocellular carcinoma and mortality were compared between the two groups. Results After treatment, the levels of albumin （ALB）, total bilirubin （TBIL） and alanine aminotransferase （ALT） in the observation group were significantly higher than those in the control group, the differences were statistically significant （P〈0.05）. In the observation group, 67 cases （97.10%） of hepatitis B virus deoxyribonucleic acid （HBV DNA） negative, 2 cases （2.90%） of hepatocellular carcinoma and 1 case （1.45%） of death occurred after treatment. In the control group, 26 cases ＇（37.68%） were HBV DNA negative, 9 cases （13.04%） were hepatocellular carcinoma, and 7 cases （10.14%） of death, the differences were statistically significant in the NBV DNA negative rate, the incidence of hepatocellular carcinoma and mortality between the two groups （P〈0.05）. Conclusion Antiviral therapy can effectively improve the clinical symptoms of patients with decompensated cirrhosis of hepatitis B, promote the recovery of liver function, and for HBV DNA replication has a certain inhibitory effect, with high clinical value, is worthy of promotion and application.