恩替卡韦在慢加亚急性肝衰竭患者中的初步临床应用  

Clinical study of entecavir treatment in patients with subacute on chronic liver failure

作　　者：于红卫[1] 李娟[1] 孟庆华[1] 冯岩梅[1] 赵敬敬[1] 王金环[1] 金怡[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病四科,北京市100069

出　　处：《实用肝脏病杂志》2008年第6期380-382,共3页Journal of Practical Hepatology

摘　　要：目的研究恩替卡韦对HBV所致的慢加亚急性肝衰竭患者生化及近期预后指标的影响。方法对14例慢加亚急性肝衰竭患者应用恩替卡韦0.5mg/日,分别比较治疗前与治疗后(4周、8周、12周、24周)的生化、凝血酶原活动度的指标及治疗第4周、12周、24周的HBV DNA定量的变化。同时应用MELD评分公式进行评价。结果治疗8、12、24周后的总胆红素(T-BIL)、谷丙转氨酶(ALT)分别与治疗前比较明显降低(P<0.01);治疗4周、8周、12周、24周的凝血酶原活动度与治疗前比较明显升高(P<0.05),治疗12周、24周的血清白蛋白(ALB)与治疗前比较均明显升高(P<0.05);治疗12周、24周的MELD评分值与治疗前相比明显降低(P=0.000,P<0.01)。第4周、12周、24周的HBVDNA定量与治疗前比较明显降低,差异有统计学意义(P=0.000)。结论恩替卡韦能有效抑制HBV的复制,改善乙型肝炎肝衰竭患者的生化指标,降低其病死率。Objective To investigate the effect of entecavir on the patients with subacute on chronic liver failure. Methods Fourteen patients with subacute on chronic liver failure were treated with entecavir 0.5mg once daily at the base of supporting treatment in this study. The indexes of biochemistry and prothrombin time activity in patients with liver failure were observed. The MELD score and serum HBV DNA levels were evaluated at 24th week treatment. Results The levels of serum T-BiL and ALT in patients with liver failure were significantly decreased after 24 week treatment（P〈 0.01）. The levels of PTA and albumin were increased （P〈0.05）. The MELD score and serum HBV DNA loads were significantly decreased after the treatment （P=0.000）. Conclusion ETV could inhibit the replication of HBV,improving the biochemistry indexes and decreasing the fatality of the patients with liver failure.

关 键 词：乙型肝炎 恩替卡韦 慢加亚急性肝衰竭 患者 临床 

分 类 号：R575.3[医药卫生—消化系统] R512.62[医药卫生—内科学]