恩替卡韦对乙型肝炎感染者疗效及血清ALT、AST、ALB水平的影响

Effects of Entecavir on Therapeutic Effect and Serum ALT,AST and ALB Levels in Hepatitis B Infected Patients

目的探讨恩替卡韦对乙型肝炎感染者疗效及血清ALT、AST、ALB水平的影响。方法选择HBeAg阳性慢性乙型肝炎(CHB)患者141例,根据入院时间予以分组,研究组(给予恩替卡韦)71例,传统组(给予富马酸丙酚替诺福韦)70例,记录研究组、传统组治疗效果,用药前后ALT、AST、ALB指标变化,肝纤维化评分情况;观察研究组、传统组不良反应情况;记录研究组、传统组HBV-DNA、HBeAg转阴率。结果研究组、传统组总有效率为94.3%、85.7%,研究组总有效率明显高于传统组(P<0.05)。研究组、传统组治疗前ALT、AST、ALB水平差异无统计学意义(P>0.05),与研究组治疗后比较,传统组ALT、AST水平下降明显,ALB水平有明显升高,研究组、传统组治疗前后各指标比较差异有统计学意义(P<0.05)。研究组、传统组治疗前肝纤维化得分差异无统计学意义(P>0.05),与研究组治疗后比较,传统组肝纤维化得分明显下降,治疗后肝纤维化得分低于治疗前(P<0.05)。研究组、传统组不良反应率依次为26.7%、42.8%,研究组腹胀人数较多,肝区不适、乏力患者均为5例,传统组食欲缺乏、腹胀人数分别为10例、11例,肝区不适、乏力人数均8例,两组不良反应比较差异有统计学意义(P<0.05),研究组有3例患者出现多种并发症,传统组有5例患者出现多种并发症。研究组、传统组HBV-DNA转阴率依次为78.8%、88.7%,HBeAg转阴率依次为57.1%、58.5%,研究组HBV-DNA、HBeAg转阴率明显高于传统组(P<0.05)。结论恩替卡韦对CHB治疗效果较好,能明显改善患者血清ALT、AST、ALB水平,提高HBV-DNA、HBeAg转阴率,但不良反应发生率较高。

Objective To investigate the effect of Entecavir on hepatitis B infected patients and the levels of serum ALT,AST and ALB.Methods 141 patients with HBeAg-positive chronic hepatitis B(CHB)were selected and divided into two groups according to the time of admission:71 patients in the study group(receiving Entecavir)and 70 patients in the traditional group(receiving Profofovir Fumarate).The therapeutic effect,ALT,AST and ALB index changes,liver fibrosis score were recorded in the study group and the traditional group before and after the treatment.The adverse reactions of the study group and the traditional group were observed.The negative conversion rates of HBV-DNA and HBeAg in study group and traditional group were recorded.Results Total effective rate of the study group and the traditional group was 94.3%and 85.7%,the effective rate of the study group was significantly higher than that of the traditional group(P<0.05).There were no significant differences in ALT,AST and ALB levels between the study group and the traditional group before treatment(P<0.05).Compared with the study group after treatment,the levels of ALT and AST in the traditional group were significantly decreased,while the levels of ALB were significantly increased.Compaed with before treatment,there were significant differences in ALT,AST and ALB in the study groap and the traditional group after treatment(P<0.05).There was no significant difference in liverfibrosis score between the study group and the traditional group before treatment(P>0.05).Compared with the study group after treatment,the liverfibrosis score of the traditional group was significantly decreased,and the liverfibrosis score after treatment was lower than that before treatment(P<0.05).The adverse reaction rate of the study group and the traditional group was 26.7%and 42.8%,respectively.In the study group,there were more patients with abdominal distension and 5 patients with liver discomfort and weakness,while in the traditional group,there were 10 cases of anorexia and 11 cases of abdominal distension,and 8 cases with liver discomfort and weakness,respectively.There was a significant difference in the ratio of adverse reactions between the two groups(P<0.05).There were 3 patients with multiple complications in the study group and 5 patients with multiple complications in the traditional group.The negative conversion rates of HBV-DNA in study group and traditional group were 78.8%and 88.7%,and the negative conversion rates of HBeAg in study group and traditional group were 57.1%and 58.5%,respectively.The negative conversion rates of HBV-DNA and HBeAg in study group were significantly higher than those in traditional group(P<0.05).Conclusion Entecavir is effective in the treatment of CHB,and can significantly improve the levels of serum ALT,AST and ALB,and increase the negative conversion rate of HBV-DNA and HBeAg,but the incidence of adverse reactions is high.