恩替卡韦治疗失代偿期乙型肝炎肝硬化患者的效果分析

Efficacy of Entecavir on Patients with Decompensated Hepatitis B Cirrhosis

目的:研究恩替卡韦(ETV)治疗失代偿期乙型肝炎(乙肝)肝硬化患者的效果。方法:选择2016年1月-2019年10月笔者所在医院的乙肝肝硬化患者60例,根据用药的不同将其分为对照组和研究组,各30例。对照组使用拉米夫定(LAM)联合阿德福韦酯(ADV)治疗,研究组使用ETV治疗。对比两组的治疗情况、肝肾功能情况、血清学指标、不良反应情况。结果:治疗半年、1年后研究组的HBV DNA转阴率(76.67%、86.67%)高于对照组的50.00%、63.33%,ALT复常率(83.33%、90.00%)高于对照组的60.00%、66.67%,差异有统计学意义(P<0.05),治疗后研究组的Cr、Child Pugh评分低于对照组,eGFR高于对照组(P<0.05),治疗后研究组的PDFG、CTGF低于对照组(P<0.05)。结论:ETV相比LAM联合ADV治疗失代偿期乙型肝炎肝硬化患者的效果更显著,能够避免损伤患者的肝肾功能,改善肝脏纤维化程度。

Objective:To study the effect of Entecavir(ETV)treatment on patients with decompensated hepatitis B(HB)cirrhosis.Method:A total of 60 patients with hepatitis B cirrhosis from January 2016 to October 2019 in our hospital were selected and divided into control and study group according to the use of medication,30 patients in each group.The control group was treated with Lamivudine(LAM)combined with Adefovir Dipivoxil(ADV),and the study group was treated with ETV.The treatment situation,liver and kidney function situation,serological indexes,and adverse effects were compared between the two groups.Result:Half a year and one year after treatment,the negative conversion rate in the study group(76.67%,86.67%)were higher than those in the control group(50.00%,63.33%),the normalization rate of ALT(83.33%,90.00%)were higher than those in the control group(60.00%,66.67%),the difference was statistically significant(P<0.05).After treatment,CR and Child Pugh scores in the study group were lower than those in the control group,eGFR was higher than that in the control group(P<0.05),PDFG and CTGF in the study group were lower than those in the control group(P<0.05).Conclusion:Compared with LAM plus ADV in the treatment of patients with decompensated hepatitis B cirrhosis,ETV is significantly more effective,can avoid damage to patients’liver and kidney function,and can improve the degree of liver fibrosis.