关键词: 肝硬化, 乙型肝炎, 多重耐药, 替诺福韦酯, 挽救治疗

Abstract: Objective To investigate the efficacy of tenofovir disoproxil（TDF） in the rescue treatment of hepatitis B liver cirrhotics with multiple drug resistant infection. Methods 80 patients with multiple drug resistant hepatitis B-induced liver cirrhosis were recruited in our hospital between October 2014 and June 2016, and they were randomly divided into two groups receiving TDF or entecavir （ETV） for rescue therapy in each 40 patients. All the patients were followed-up for 48 weeks. Results At the end of 24 weeks,serum ALT normalization and HBV DNA negativity rates in TDF-treated group were 70.0% and 82.5%,much higher than 50.0% and 65.0%,respectivley（P<0.05） in ETV-treated gruop;at the end of 48 weeks,they were 92.5% and 95.0%,much higher than 70.0% and 75.0%,respectively（P<0.05） in ETV-treated group;at the end of 48 w regimen,serum ALT, ALB, Child-Pugh score and liver stiffness measurement were （45.6±10.4）IU/L,（35.2±1.9）g/L,（6.3±1.1） and （14.5±2.5） kPa,significantly different as compared to 【（58.7±11.4）IU/L,（33.5±2.0）g/L, （7.9±1.2） and （17.5±2.8） kPa,P<0.05】,respectively,in patients receiving ETV treatment;serum renal function index and phosphorus had no significant changes in the two groups,and viral breakthrough occurred in one （2.5%） and in two （5.0%） patients in the two groups（P>0.05）. Conclusions TDF has the ability to effectively inhibit HBV replication,and could improve the liver functions of patients with hepatitis B-induced liver cirrhosis. It is safe and reliable and might be used as an effective alternative agent for rescue therapy for patients with multi-drug resistance infection.

Key words: Liver cirrhosis, Hepatitis B, Multi-drug resistance, Tenofovir disoproxil, Rescue therapy