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| 恩替卡韦治疗慢加急性乙型肝炎肝衰竭疗效的Meta分析 | |
| 引用本文： | 毛海鹰,廖礼艳,胡秋菊,华杨,韩志超. 恩替卡韦治疗慢加急性乙型肝炎肝衰竭疗效的Meta分析[J]. 实用肝脏病杂志, 2015, 18(5): 491-495. DOI: 10.3969/j.issn.1672-5069.2015.05.011 |
| 作者姓名： | 毛海鹰 廖礼艳 胡秋菊 华杨 韩志超 |
| 作者单位： | 644000 四川省宜宾市第三人民医院感染病科 |
| 摘 要： | 目的 系统评价恩替卡韦治疗慢加急性乙型肝炎肝衰竭的疗效和安全性。方法 应用计算机检索PubMed、Cochrane Library、CBMdisc、CNKI、维普、万方等数据库公开发表的文献，检索年限均从2006年1月至2014年9月。纳入恩替卡韦与拉米夫定相比较治疗慢加急性乙型肝炎肝衰竭的随机对照试验。由两名评判员对纳入试验独立进行质量评价和资料提取，采用RevMan5.1软件进行Meta分析。结果 经筛选共纳入7个随机对照试验，合计823例患者。Meta分析结果显示，恩替卡韦治疗6月以上的患者其病死率显著低于拉米夫定治疗患者[RR=0.75，95%CI（0.60，0.95），P＜0.05]；在治疗2～3 m和6 m以上评价，恩替卡韦治疗患者HBV DNA转阴率也显著高于拉米夫定治疗患者[RR=1.47，95%CI（1.29，1.68），P＜0.05；RR=1.48，95%CI（1.30，1.67），P＜0.05]，病毒学突破率也显著低于拉米夫定治疗组[RR=0.07，95%CI（0.01，0.54），P＜0.05]，且未出现严重不良反应。结论 恩替卡韦治疗慢加急性乙型肝炎肝衰竭患者的远期病死率和病毒学突破率均显著低于拉米夫定，适合于长期抗病毒治疗。 |
| 关 键 词： | 慢性乙型肝炎 肝衰竭 恩替卡韦 Meta分析 |
| 收稿时间： | 2014-11-14 |
Efficacy of entecavir in treatment of patients with hepatitis B virus-related acute-on-chronic liver failure: a Meta-analysis |
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| Mao Haiying,Liao Liyan,Hu Qiuju,et al.. Efficacy of entecavir in treatment of patients with hepatitis B virus-related acute-on-chronic liver failure: a Meta-analysis[J]. Journal of Clinical Hepatology, 2015, 18(5): 491-495. DOI: 10.3969/j.issn.1672-5069.2015.05.011 | |
| Authors: | Mao Haiying Liao Liyan Hu Qiuju et al. |
| Affiliation: | Department of Hepatology and Infectious Diseases，Third People's Hospital，Yibin 644000，Sichuan Province，China |
| Abstract: | Objective To evaluate the efficacy and safety of entecavir in treatment of patients with hepatitis B virus （HBV）-related acute-on-chronic liver failure. Methods All randomized controlled trials comparing the efficacy of entecavir versus lamivudine in patients with HBV-related acute-on-chronic liver failure published in January 2006 to September 2014 were collected by searching PubMed，Cochrane Library，CBMdisc，Chinese National Knowledge Infrastructure（CNKI），Chinese VIP database and WanFang database. The quality assessment of literatures and the extraction of information were accomplished by two independent reviewers. Statistical analyses were performed with RevMan 5.1 software. Results Seven eligible trials including 823 patients were included. According to the results of meta-analysis，the mortality rates of patients in entecavir groups were significantly lower than that of patients in lamivudine groups when the treatment lasted for more than 6 months [RR=0.75，95%CI （0.60，0.95），P<0.05]；the negative conversion rates of serum HBV DNA in patients of entecavir groups were significantly higher than that of patients in lamivudine groups when the treatment lasted for 2 to 3 months and more than 6 months[RR=1.47，95%CI（1.29，1.68），P<0.05;RR=1.48，95%CI（1.30，1.67），P<0.05]，and the virological breakthrough rate of patients in entecavir groups was significantly lower as compared to that of patients in lamivudine groups [RR=0.07，95%CI（0.01，0.54），P<0.05]. No serious adverse events were observed in the entecavir groups. Conclusion Entecavir leads to lower long-term mortality rate and virological breakthrough rate than lamivudine in patients with HBV-related acute-on-chronic liver failure，providing a better option for the long-term antiviral therapy. |
| Keywords: | Hepatitis B Liver failure Entecavir Meta-analysis |
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