替比夫定治疗慢加亚急性乙型肝炎肝衰竭的疗效观察  

A study on the treatment effect of telbivudine on hepatitis B patients with acute on chronic liver failure

作　　者：张骏飞[1] 郭远[1] 陈从新[1] 宋海燕[1] 董静[1] 陈曦[1] 陈照林[1] 刘波[1] 

机构地区：[1]解放军105医院感染病科,安徽合肥230031

出　　处：《东南国防医药》2016年第2期131-134,共4页Military Medical Journal of Southeast China

基　　金：解放军105医院院管课题项目(10Y915)

摘　　要：目的探讨替比夫定治疗慢加亚急性乙型肝炎肝衰竭患者104周的临床疗效和基因变异情况。方法共纳入80例慢加亚急性乙型肝炎肝衰竭患者,治疗组41例,对照组39例,分别在常规治疗的基础上使用替比夫定、拉米夫定治疗,每3~6个月进行HBV DNA、ALT、TBIL、INR及HBe Ag检测,判断疗效。结果在治疗52周和104周时,治疗组HBe Ag转阴率分别是54.2%和62.5%,与对照组HBe Ag转阴率和转换率16.0%和20.0%比较差异有统计学意义（P〈0.05）。结论替比夫定能够迅速抑制HBV复制,HBe Ag血清学转阴率和转换率高,能阻断病情发展,适合慢加亚急性乙型肝炎肝衰竭患者治疗。Objective We conducted a pilot clinical trial to observe the efficacy of telbivudine in the treatment of hepatitis B patients with acute on chronic liver failure. Methods We randomly divided hepatitis B patients with acute on chronic liver failure into two groups. One group（ n = 41） was treated with telbivudine for two years,while the other（ n = 39） with lamivudine for two years.HBV DNA,ALT,TBIL,INR and HBe Ag level of these patients were tested every 3- 6 months. Results During a total of 104 treatment weeks,there were no significant difference in the change of the leves of ALT,TBIL,INR and the motality rate. However,the loss and seroconversion rate of HBe Ag at week 52 week and 104 week were significantly higher in the telbivudine group than in the lamivudine group（ 54. 2% vs 16. 0%,62. 5% vs 20. 0%,P 0. 05）. Conclusion Telbivudine has an strong anti-HBV activity and a rapid effect. It can block the disease development for hepatitis B patients with liver failure.

关 键 词：替比夫定 拉米夫定 乙型肝炎 肝衰竭 

分 类 号：R512.62[医药卫生—内科学]