拉米夫定和恩替卡韦治疗慢性乙型重型肝炎近期疗效观察

目的观察拉米夫定(LAM)和恩替卡韦(ETV)治疗慢性乙型重型肝炎的近期疗效。方法回顾性研究慢性乙型重型肝炎住院患者102例,其中对照组(20例)给予常规内科综合治疗,治疗组分别在综合治疗基础上加用LAM(56例)或ETV(26例)抗病毒治疗。结果治疗8、12周时,治疗组TB及MELD评分均较对照组明显降低(P<0.05),PTA较对照组明显升高(P<0.05),治疗12周时治疗组好转率和HBV DNA低于检测下限的比率明显高于对照组(P<0.05)。治疗前MELD评分≤30分时,治疗组好转率高于对照组(P<0.05),而MELD评分>30分时,治疗组与对照组比较差异无统计学意义(P>0.05)。LAM组与ETV组间的疗效差异无统计学意义。结论 LAM和ETV治疗慢性乙型重型肝炎均有较好疗效,但应早期应用。

The short-term effects of lamivudine and entecavir therapy on chronic severe hepatitis B

Objective To evaluate the short-term effects of lamivudine （LAM） and entecavir （ETV） therapy on chronic severe hepatitis B. Methods Total of 102 cases with chronic severe hepatitis B were analyzed, retrospectively. The control group （20 cases） received conventional therapy and the therapy groups were treated with LAM （56 cases） or ETV （26 cases） based on the comprehensive therapy. Results After 8 and 12 weeks therapy, the total bilirubin （TB）, international normalized ratio （INR） for prothrombin time and MELD score in the therapy groups were significantly lower than those in the control group （P 〈 0.05）. After 12 weeks therapy the improvement rates and HBV DNA undetectable in the therapy groups were significantly higher （P 〈 0.05）. According to the MELD score before therapy, all patients were divided into two groups and the improvement rates in the therapy groups were higher than those in the control group when MELD score ≤ 30 （P 〈 0.05）, while no significant differences were found when MELD score 〉 30 （P 〉 0.05）. No significant differences of short-term effects were found between LAM group and ETV group. Conclusions LAM and ETV are both beneficial for chronic severe hepatitis B and should be used as early as possible.