恩替卡韦对慢性乙型肝炎伴慢加急性肝衰竭患者凝血功能及预后影响分析

Effect of entecavir on coagulation function and prognosis in patients with chronic hepatitis B complicated with chronic and acute liver failure

目的分析恩替卡韦对慢性乙型肝炎伴慢加急性肝衰竭患者凝血功能及预后的影响。方法收集医院收治的慢性乙型肝炎伴慢加急性肝衰竭患者65例,随机分为观察组33例和对照组32例。对照组接受常规内科治疗,观察组在对照组治疗基础上加用恩替卡韦治疗。治疗24周后比较2组患者肝功能、凝血功能指标。结果治疗后,2组总胆红素(TBiL)、天冬氨酸氨基转氨酶(AST)、谷氨酸氨基转氨酶(ALT)数值较治疗前均降低,且观察组TBiL数值低于对照组(P<0.01),2组治疗后AST、ALT数值比较差异无统计学意义(P>0.05)。治疗后,2组血酶原时间(PT)、国际标准化比值(INR)数值较治疗前均降低,纤维蛋白原(Fbg)较治疗前升高,且观察组PT、INR数值低于对照组,Fbg高于对照组(P均<0.01)。结论恩替卡韦能够明显增强乙型肝炎病毒抑制效果,改善慢性乙型肝炎伴慢加急性肝衰竭患者的凝血功能及近期预后,且未增加不良反应,值得临床重视。

Objective To analyze the effect of entecavir on coagulation function and prognosis in patients with chronic hepatitis B complicated with chronic and acute liver failure.Methods Sixty-five patients with chronic hepatitis B complicated with chronic and acute liver failure were randomly divided into observation group(33 cases)and control group(32 cases).The control group received routine medical treatment,while the observation group was treated with entecavir on the basis of the control group.After 24 weeks of treatment,the indexes of liver function and coagulation function were compared between the two groups.Results After treatment,the values of total bilirubin(TBi L),aspartate aminotransferase(AST),glutamate aminotransferase(ALT)in the two groups were lower than those before treatment,and the TBi L values in the observation group were lower than those in the control group(P<0.01).There was no significant difference in AST and ALT between the two groups after treatment(P>0.05).After treatment,the values of PT and INR in the two groups were lower than those before treatment,and fibrinogen(Fbg)was higher than that before treatment.The values of PT and INR in the observation group were lower than those in the control group,and Fbg was higher than those in the control group(all P<0.01).Conclusion Entecavir can significantly enhance the inhibitory effect of hepatitis B virus,improve coagulation function and short-term prognosis of patients with chronic hepatitis B accompanied by chronic and acute liver failure,without increasing adverse reactions,which deserves clinical attention.