恩替卡韦治疗失代偿期乙型肝炎肝硬化的疗效观察

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1、恩替卡韦治疗失代偿期乙型肝炎肝硬化的疗效观杨静朱萱王河(南昌大学第一附属医院消化科，南昌336000)通信作者：朱萱E-ina订jyyfyzx@163.com摘要目的观察恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周的安全性和疗效。方法80例患者随机分为恩替卡韦(ETV)组和对照组各40例，疗程48周，观察治疗前、后生化指标、Child-Pugh评分、HBV1DNA标志物及HBVDNA。结果治疗4周时,ETV组HBVDNA下降幅度、HBVDNA不可测率、ALT复常率分别为2.261gIU/mK50.0%、30.0%,均分别高于对照组(AO.05)o且随着疗程延长,均逐渐

2、升高,在12、24、48周时,ETV组HBVDNA下降幅度、HBVDNA不可测率、ALT复常率均分别高于对照组(/KO.05)oETV组24、48周HBeAg阴转率均高于对照组(/二4.560,尺0.033；X-7.892,7^0.005)；治疗24、48周时，ETV组HBeAg血清学转换率与对照组比较,差异均无统计学意义(/二0.950,P二0.330；才二3.206,/壬0.073)。ETV组Child-Pugh分级均明显改善，ChildA级患者比例增加，高于对照组(力二26.898,7K0.05),ETV组出现疾病进展的比例低于对照组(才二8.352,KQ.05

3、)o恩替卡韦组ALT、TBTL、HBVDNA、Child-Pugh评分下降，分别低于对照组(F均＞0.05)；ALB、PTA±升，分别高于对照组(戶均＜0.05)o48周内ETV组无耐商发生。结论ETV治疗失代偿期乙肝肝硕化能强效、快速抑制HBVDNA复制，改善Ch订d-Pugh分级和肝功能，延缓病情进展，耐药率低，耐受性好。关键词：恩替卡韦；肝炎，乙型，慢性AntiviraleffectsofentecavirinpatientswithhepatitisBvirus-induceddecompensatedlivercirrhosisYANGJing,ZHUXua

4、n,WANGHe.(DepartmentofGastroenterology,TheFirstAffiliatedHospitalofNanchangUniversity,Nanchang336000,China)Abstract:ObjectiveToanalyseantiviraleffectsofentecavir(ETV)inpatientswithHBV-induceddecompensatedcirrhosis.Methods8()caseswererandomlydividedintoentecavirgroup(n=40)andcontrolgroup

5、(n=40)for48weeks.HBVDNA,liverfunctionandChild-Pughscoreswereobservedatdifferenttimepoints.ResultsAtweek4,mean作者简介：杨静，女，硕士，副主任医师，主要从事消化系统疾病的临床与基础研究通信作者:朱萱，电话:(0791)8692505,E-mail：jyyfyzx@163.comreductionofHBVDNAwas2.26lglU/ml,50.0%ofthepatientsachievedundetectableHBVDNAand30.0%achievedAL

6、TnormalizationinETVgroup.Atweek4,12,24,4&thedifferencesofmeanreductionofHBVDNA,undetectableHBVDNAandALTnormalizationwerestatiscallysignificantbetweenthetwogroups,respectively.ThedifferenceofHBeAgnegativeconversionratesatweek24,48weresignificantandtheHBeAgseroconversionatweek24,48werenos

7、ignificantbetweenthetwogroups-ThedifferencesoftheimprovementofChild-PughscoresandthemeanlevelofALT,TBIL,HBVDNA,ALB,PTAandChild-PughscoreswerestatisticallysignificantbetweenETVgroupandcontrolgroup,respectively.ConclusionEntecavirtreatmentresultsinsuppressionofHBVreplicationandim