核苷酸类似物治疗失代偿期乙型肝炎肝硬化死亡原因分析

目的探讨接受核苷（酸）类似物治疗失代偿期乙型肝炎肝硬化患者对生存期和死亡原因的影响.方法在60例失代偿期乙型肝炎肝硬化死亡患者中,20例曾接受过抗病毒治疗,40例未曾抗病毒治疗.结果两组在肝性脑病、上消化道出血、肝肾综合征和感染的发生率方面比较,无统计学差异（P〉0.05）;在性别、年龄、肝炎病程和肝功能分级方面比较,无统计学差异（P〉0.05）;抗病毒组和未抗病毒组患者肝硬化病程分别为62.5±41.1月和30.5±45.0月（P〈0.05）,3年生存率为75.0%和37.5%（P〈0.01）,但在5年、7年和9年生存率方面比较,无统计学差异（P〉0.05）.结论抗病毒治疗失代偿期乙型肝炎肝硬化能提高3年生存率,但不能避免并发症的发生.

The analysis of death in patients with hepatitis B-induced decompensated liver cirrhosis receiving the treatment of nucleotide analogues

Objective To analyze the causes of death in patients with hepatitis B-induced decompensated liver cirrhosis receiving the treatment of nucleotide analogues. Method Among 60 dead patients with hepatitis B- induced decompensated liver cirrhosis,20 patients had accepted the treatment of nucleotide analogues and 40 patients had not. Result There was no statistical significance with respect to the incidence of hepatic encephalopathy,upper gastrointestinal bleeding,hepatorenal syndrome and infection between the two groups（P〉0.05）;there was also no statistical significance to gender,age,course of hepatitis and grades of liver function （P〉0.05） in the two groups;the cirrhosis course in patients receiving anti-viral treatment was 62.5±41.lmonths, much longer than 30.5± 45.0months in patients without therapy of nucleotide analogues （P〈0.05）;the 3-year survival rates was 75.0% in the former,much higher than 37.5% in the latter （P〈0.01）,but there was no statistical significance comparing 5-year,7- year and 9-year survival rate between the two groups （P〉0.05）. Conclusion The anti-viral treatment in patients with hepatitis B-induced decompensated liver cirrhosis can increase the 3-year survival rate,but can not avoid the occurrence of complications.