恩替卡韦治疗乙型肝炎肝硬化病毒耐药的临床观察

目的观察恩替卡韦治疗乙型肝炎肝硬化48周后的疗效及病毒耐药位点变异情况。方法收集近2年门诊或住院患者,其中恩替卡韦治疗乙型肝炎肝硬化患者19例,采用恩替卡韦0.5 mg/d治疗,同时阿德福韦治疗组(10mg/d)23例、替比夫定治疗组(600 mg/d)15例、拉米夫定治疗组(100 mg/d)14例,于治疗48周后观测其肝功能、Child-Pugh分级以及血清HBV DNA自基线下降的水平。结果治疗48周后各治疗组患者肝功能、Child-Pugh分级以及血清HBV DNA自基线下降的水平与治疗前比较均有显著性差异,而且恩替卡韦未出现耐药方面的相关表现。结论恩替卡韦能改善活动性乙型肝炎肝硬化肝功能,疗效与其他核苷类似物比较无显著性差异,但耐药方面表现较其他药物为优。

Observation on clinical efficacy and drug resistance of entecavir in patients with hepatitis B-related cirrhosis

Objective To evaluate the efficacy of emecavir in treatment of active cirrhosis due to chronic hepatitis B. Methods Sixty - eight patients with active cirrhosis of hepatitis B virus infection were randomly divided into trial group （36 cases） and control group （32 cases）, and they were evaluated with liver function, Child - Pugh scores and reduction of serum HBV DNA from baseline （copies/ml） after treatment for 48 weeks. Patients in trial group were treated with entecavir 0.5 mg orally once daily, and supportive treatment. Results There was significant difference in liver function, Child - Pugh scores, and reduction of serum level of HBV DNA from baseline （copies/ml） after treatment for 48 weeks between these two groups. Conclusion Entecavir therapy can result in significant improvement of liver function and prolonging survival time in patients with active HBV cirrhosis, and it can effectively decrease serum level of HBV DNA.