乙型肝炎肝硬化抗病毒治疗安全性与疗效观察  

Clinical observation on 69 cases of decompensated cirrhosis patients following chronic hepatitis B virus infection treated with entecavir and other nucleoside drugs

作　　者：李冰[1] 李梵[1] 纪冬[1] 张健[1] 邵清[1] 韩萍[1] 李永纲[1] 陈国凤[1] 王慧芬[1] 陈菊梅[1] 

机构地区：[1]北京解放军第三○二医院,100039

出　　处：《肝脏》2010年第1期8-10,共3页Chinese Hepatology

基　　金：军队"十一五"中医药研发推广专项重大临床攻关课题(2006231001)

摘　　要：目的观察恩替卡韦等核苷类似物在乙型肝炎肝硬化失代偿期患者中抗病毒治疗的安全性与疗效。方法69例乙型肝炎肝硬化失代偿期患者随机分成2组,分别给予恩替卡韦、拉米夫定联合阿德福韦酯两种方案,观察所有病例症状、体征、生化学指标、HBV DNA阴转、HBeAg阴转、抗-HBe阳转以及Child-Pugh评分分级变化等情况。结果两组患者无一例死亡,临床症状、体征、肝功能均有明显改善,HBeAg血清转换率分别为42.1%、41.9%,差异无统计学意义(P>0.05),HBV DNA阴转率两组分别为92.1%、84.1%,组间比较差异无统计学意义(P>0.05)。结论乙型肝炎肝硬化失代偿期患者选用恩替卡韦或拉米夫定联合阿德福韦酯安全性及疗效无显著差异。Objective To determine the clinical therapeutic effect and security of entecavir and other nucleoside drugs on decompensated cirrhosis patients following chronic hepatitis.Methods Sixty-nine cases of hepatitis B patients with cirrhosis were randomly divided into 2 groups.Patients in group A and B were treated with entecavir and combination of lamivudine with adefovir for 48 weeks,respectively.Clncal manifestations,biochemical indicators,Child-Pugh classification,HBV DNA loads,HBeAg and anti-HBe situations were recorded.Results After anti-viral treatment for 48 weeks,no patients died in the study groups.Decompensated cirrhosis patients were significantly improved in clinical symptoms,body signs,liver functions.HBeAg seroconversion rates of the two groups were not statistically significant（42.1% and 41.9%,P0.05）.Similarly no significant difference of HBV DNA negative conversion rate in the two groups（92.1% and 84.1%,P0.05）.Conclusion Treatment of entecavir or adefovir combined with lamivudine on hepatitis B patients with cirrhosis was not significantly different.

关 键 词：肝硬化 失代偿 抗病毒治疗 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]