关键词: 肝硬化, 乙型肝炎, 恩替卡韦, 肝组织学北京分型, 治疗

Abstract: Objective The aim of this study was to investigate antiviral efficacy of entecavir (ETV) based on Beijing Standard in patients with hepatitis B-induced liver cirrhosis (LC). Method 145 patients with hepatitis B-induced LC were treated with ETV for 12 months in our hospital between July 2021 and July 2024. Serum HBV DNA loads were detected by PCR, and liver stiffness measurement (LSM) was finished by FibroScan 502 elastography. Liver biopsies was completed and evaluated by Ishak and Knodell scores, and reassessed by Beijing standard for predominantly progressive (P), indeterminate(I) and predominately regressive (R) typing. Result By end of 12 month treatment, liver histo-pathological examination showed out of the 145 patients with LC, liver injuries demonstrated in P typing, I typing and R typing were 45 cases(31.0%), 32 cases (22.1%) and 68 cases (46.9%), respectively; alcohol hobby, serum HBV DNA load and HBsAg levels at baseline in P group were 46.7%, (7.6±1.8)lg IU/mL and (8751.9±220.5)IU/mL, all significantly higher than [23.5%, (5.7±1.6)lg IU/mL and (2003.0±60.9)IU/mL, respectively, P<0.05] in R group or [34.4%, (6.5±1.7)lg IU/mL and (4312.4±111.4)IU/mL, respectively, P<0.05] in I group; by end of 12 month treatment, serum ALT, AST, LSM, Ishak score and histological activity index score in P group were (47.9±13.1)U/L, (53.1±14.2)U/L, (6.7±1.7)kPa, (3.6±0.4) points and (5.1±0.5)points, all significantly higher than [(36.2±10.9)U/L, (37.0±11.2)U/L, (5.2±1.2)kPa, (3.2±0.3) points and (4.5±0.3)points, respectively, P<0.05] in R group; serum ALT normalization rate and HBV DNA loss rate in P group were 46.7% and 71.1%, both much lower than 100.0% and 100.0%(P<0.05) in R group. Conclusion Liver histo-pathological response to ETV antiviral treatment varies, which might assessed by Beijing standard for efficacy classification.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, PIR typing, Therapy