替比夫定与拉米夫定治疗活动性乙型肝炎肝硬化的疗效比较

Comparison of telbivudine and lamivudine in treating active cirrhosis resulting from hepatitis B

目的探讨替比夫定与拉米夫定治疗活动性乙型肝炎肝硬化的疗效。方法选择我院2009年1月-2011年2月治疗的活动性乙型肝炎肝硬化患者72例分为观察组(n=36)和对照组(n=36)。观察组在常规治疗基础上给予替比夫定,对照组在常规治疗基础上给予拉米夫定,疗程均为48周,观察比较两组患者在治疗前及治疗24周、48周的肝功能指标ALT、TBIL、ALB和血清HBVDNA水平变化,比较治疗48周时ALT复常率、HBVDNA阴转率和HBeAg转阴率。结果两组患者治疗24周、48周肝功能及血清HBVDNA水平均有明显改善,观察组治疗24周、48周ALT、TBIL和血清HBVDNA水平比对照组下降明显,两组比较差异有统计学意义(P【0.05);两组治疗后24周、48周ALB比较差异无统计学意义(P】0.05)。治疗48周时观察组ALT复常率、HBVDNA阴转率和HBeAg转阴率比对照组高,但两组比较差异无统计学意义(P】0.05)。结论替比夫定治疗活动性乙型肝炎肝硬化可有效抑制患者体内病毒复制,明显改善肝功能,疗效确切,值得临床推广应用。

Objective To explore the efficacy of telbivudine and lamivudine in treatment of active cirrhosis resulting from chronic hepatitis B.Methods A total of 72 patients with active cirrhosis resulting from hepatitis B admitted to our hospital from Jan.2009 to Feb.2011 were randomly divided into observation group and control group,with 36 cases in each group.The observation group was received telbivudine based on conventional therapy and the control group was given lamivudine conventional therapy for 48 weeks of course of treatment.The levels of ALT,TBIL,ALB and HBV DNA were observed before and after 24 weeks and 48 weeks of treatment.The recover rate of ALT,HBV DNA negative rate and HBeAg negative rate were compared between the two groups.Results The hepatic function and level of HBV DNA were significant improved after 24 weeks and 48 weeks of treatment(P<0.05).The levels of ALT,TBIL and HBV DNA of the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference of the recover rate of ALT,HBV DNA negative rate and HBeAg negative rate between the two groups(P>0.05).Conclusion Telbivudine can inhibit HBV replication and improve liver function inpatients with active cirrhosis resulting from hepatitis B.