乙肝肝硬化合并脾亢脾切除术后应用恩替卡韦的疗效分析  

作　　者：方亮[1] 张敏燕[1] 

机构地区：[1]广州市第一人民医院感染科,510518

出　　处：《当代医学》2012年第23期29-31,共3页Contemporary Medicine

摘　　要：目的探讨乙型肝炎肝硬化合并脾功能亢进患者行脾脏切除术后恩替卡韦的治疗效果。方法治疗组32例于脾脏切除术后立即予以恩替卡韦0.5mg/d口服,同时给予常规治疗;对照组31例,脾脏切除术后仅予常规治疗。监测两组患者血清HBV-DNA定量、肝功能、外周血细胞及Child-Pugh评分及并发症情况。结果治疗组12周时,HBV-DNA阴转率75.0%,明显高于对照组6.5%(P<0.01),但生化各指标与对照组无显著差异(P>0.05);治疗48周后治疗组HBV-DNA水平显著下降,阴转率高达87.5%,白蛋白明显回升,胆红素、转氨酶明显下降,外周血细胞明显升高,Child-Pugh评分显著下降,上消化道出血、肝性脑病等并发症出现较少,治疗效果明显优于对照组。对照组实验室各指标则无显著变化,上消化道出血、腹水出现较多。结论恩替卡韦是乙肝肝硬化合并脾功能亢进患者行脾脏切除术后较为安全、有效的长期抗病毒药物。Objective To evaluate the effect and safety of 48weeks entecavir treatment for chronic hepatitis patients with cirrhosis after their splenectomy. Methods Sixty-three chronic hepatitis Patients were randomly put into twogroups,Patients in treatment group after their splenectomy received routine colligative treatment and entecavir 0.5mg daily, while patients in the control group received routine colligative treatment only after their splenectomy. The course of treatment lasted 48weeks.Serum levels of ALT, AST, ALB,TBil,HBVDNA,blood cells,Child-Pugh scores and upper gastrointestinal bleeding,hepatic encephalopathy complications during the treatment of the two groups were checked, compared and analyzed. Results In the treatment group,the ratio of negative transformation of HBV-DNA was obviously increased than the control group at the 12thweek （P〈0.01）. At the 48thweek the ratio of negative transformation of HBV-DNA were separately 87.5%,Which was superior to the control group; serum ALT,AST, ALB,TBil levels dropped,the serum albumin level increased,and the Child-Pugh score decreased.The improvement of liver function in the treatment group was better than that in the control group. Upper gastrointestinal bleeding,hepatic encephalopathy etc. complications few happened. In the control group,HBV-DNA,serum ALT, AST, ALB,TBil,the serum albumin level and the Child-Pugh score have no significant changes,Upper gastrointestinal bleeding,hepatic encephalopathy ete.eomplieations were more than treatment group. Conclusion Entecavir is a long-term safe and efficient drug for chronic hepatitis B patients With cirrhosis after their splenectomy.

关 键 词：乙肝肝硬化 恩替卡韦 脾切除术 

分 类 号：R575.2[医药卫生—消化系统]