替比夫定治疗慢加亚急性乙型肝炎肝衰竭的疗效观察

目的：探讨替比夫定治疗慢加亚急性乙型肝炎肝衰竭患者104周的临床疗效和基因变异情况。方法共纳入80例慢加亚急性乙型肝炎肝衰竭患者，治疗组41例，对照组39例，分别在常规治疗的基础上使用替比夫定、拉米夫定治疗，每3～6个月进行HBV DNA、ALT、TBIL、INR及HBeAg检测，判断疗效。结果在治疗52周和104周时，治疗组HBeAg转阴率分别是54．2％和62．5％，与对照组HBeAg转阴率和转换率16．0％和20．0％比较差异有统计学意义（ P＜0．05）。结论替比夫定能够迅速抑制HBV复制，HBeAg血清学转阴率和转换率高，能阻断病情发展，适合慢加亚急性乙型肝炎肝衰竭患者治疗。

A study on the treatment effect of telbivudine on hepatitis B patients with acute on chronic liver failure

Objective We conducted a pilot clinical trial to observe the efficacy of telbivudine in the treatment of hepatitis B patients with acute on chronic liver failure. Methods We randomly divided hepatitis B patients with acute on chronic liver failure into two groups. One group (n=41) was treated with telbivudine for two years, while the other (n=39) with lamivudine for two years. HBV DNA, ALT, TBIL, INR and HBeAg level of these patients were tested every 3-6 months. Results During a total of 104 treat?ment weeks, there were no significant difference in the change of the leves of ALT, TBIL, INR and the motality rate. However, the loss and seroconversion rate of HBeAg at week 52 week and 104 week were significantly higher in the telbivudine group than in the lamivu?dine group(54.2% vs 16.0%, 62.5% vs 20.0%, P<0.05). Conclusion Telbivudine has an strong anti?HBV activity and a rapid effect. It can block the disease development for hepatitis B patients with liver failure.