恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周临床观察

doi:10.3969/j.issn.1672-5069.2012.05.0012

实用肝脏病杂志 ›› 2012, Vol. 15 ›› Issue (5): 407-410.doi: 10.3969/j.issn.1672-5069.2012.05.0012

恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周临床观察

杨晋辉, 郑盛, 尤丽英, 唐映梅, 刘海

650000 昆明市昆明医学院第二附属医院肝胆胰内科（杨晋辉,尤丽英,唐映梅）;
云南省第三人民医院消化内科（郑盛,刘海）

收稿日期:2011-11-14 出版日期:2012-10-10 发布日期:2017-03-09
通讯作者: 郑盛,E-mail:zheng_sheng523@163.com
作者简介:杨晋辉男,50岁,医学硕士,教授,主任医师。主要从事肝病的基础与临床研究。E-mail: yangjinhui_med@126.com

Therapeutic effects of 48-week entecavir treatment in patients with decompensated cirrhosis caused by hepatitis B virus

Yang Jinhui, Zheng Sheng, You Liying, et al.

Department of Gastroenterology,Yunnan Third People’s Hospital,Kunming 650011,China

Received:2011-11-14 Online:2012-10-10 Published:2017-03-09

摘要/Abstract

摘要： 目的观察恩替卡韦治疗乙型肝炎肝硬化患者48周疗效。方法采用随机、对照队列研究方法,将98例乙型肝炎肝硬化患者分成三组,恩替卡韦（ETV）组32例,拉米夫定（LAM）组42例,对照组24例,采用常规保肝对症治疗,疗程均为48周。观察治疗不同时间点患者的病毒学、生化学、凝血酶原时间（PT）、肝纤维化指标及Child-Pugh计分等变化情况。结果 ETV组患者HBV DNA水平显著下降,由治疗前的（6.6±1.0）log10拷贝/ml分别降低为治疗后12周、24周和48周的（3.1±1.2）、（2.8±1.1）和（2.8±1.0）log10拷贝/ml,HBV DNA转阴率优于LAM组和对照组,12周、24周、48周时依次为（59.4%、31.0%、0.0%;84.4%、66.7%、0.0%;87.5%、69.0%、0.0%）,差异均有统计学意义（P<0.05）。在24和48周ETV组患者血清HBeAg阴转率及HBeAg/抗-HBe血清学转换率（47.6%,23.8%;52.4%,38.1%）与对照组（0.0%、0.0%;0.0%,0.0%）比较,差异有统计学意义（P<0.05）。ALT、AST、TBil明显下降,肝纤维化指标改善,Child-Pugh计分下降,在24和48周,ETV组和LAM组较治疗前比较差异有统计学意义（P<0.05）。结论 ETV治疗乙型肝炎肝硬化患者能有效、快速抑制病毒复制,改善肝功能、肝纤维化指标及Child-Pugh计分等。

关键词: 慢性乙型肝炎, 肝硬化, 恩替卡韦, 拉米夫定

Abstract: Objective To analyze the therapeutic effects of 48-week entecavir treatment in patients with decompensated cirrhosis caused by hepatitis B virus（HBV）. Methods In this cohort study,98 patients with liver cirrhosis caused by HBV were divided into three groups randomly: entecavir（ETV） group （n=32）,lamivudine （LAM） group（n=42）,and control group（n=24）:conventional liver protection treatment. The course of treatment lasted 48 weeks. The virological and biochemical parameters,PT,hepatic fibrosis index and Child-Pugh scores were observed at different time points during treatment. Results The HBV DNA levels in entecavir group were significantly decreased. The negative rates of HBV DNA（<500 copies/ml） were correspondingly and significantly higher than those in lamivudine group and control group（P<0.05）. At week 24 and 48,the negative rates of hepatitis B e antigen（HBeAg） and the rates of HBeAg/anti-HBe sero-conversion in entecavir group were higher than those in control group（P<0.05）. ALT,AST,total bilirubin, hepatic fibrosis index and Child-Pugh scores were significantly improved in entecavir group and lamivudine group after treatment（P<0.05）. Conclusion Entecavir can rapidly and effectively inhibit HBV DNA replication and improve liver function,hepatic fibrosis index and Child-Pugh scores in patients with liver cirrhosis caused by HBV.

Key words: Chronic hepatitis B, Cirrhosis, Entecavir, Lamivudine

杨晋辉, 郑盛, 尤丽英, 唐映梅, 刘海. 恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周临床观察[J]. 实用肝脏病杂志, 2012, 15(5): 407-410.

Yang Jinhui, Zheng Sheng, You Liying, et al.. Therapeutic effects of 48-week entecavir treatment in patients with decompensated cirrhosis caused by hepatitis B virus[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2012, 15(5): 407-410.

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恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周临床观察

Therapeutic effects of 48-week entecavir treatment in patients with decompensated cirrhosis caused by hepatitis B virus

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