核苷（酸）类似物抗病毒治疗慢性重型乙型肝炎的疗效观察

目的评价核苷（酸）类似物抗病毒治疗慢性重型乙型肝炎的疗效。方法治疗组65例慢性重型乙型肝炎患者在内科综合治疗基础上加用核苷（酸）类似物抗病毒治疗,对照组63例慢性重型乙型肝炎患者只采用内科综合治疗,比较2组血清总胆红素（TBil）、丙氨酸氨基转移酶（ALT）、凝血酶原活动度（PTA）、乙肝病毒DNA（HBV-DNA）水平和病死率。结果治疗1个月后2组PTA高于治疗前,但2组升高水平比较差异无统计学意义（P〉0.05）;2组TBil、ALT和HBV-DNA水平均低于治疗前,但2组降低水平比较差异无统计学意义（P〉0.05）;治疗组死亡6例（9.2%）,对照组死亡6例（9.5%）,2组比较差异无统计学意义（P〉0.05）。治疗3个月后2组PTA均高于治疗前,且治疗组高于对照组,差异均有统计学意义（P〈0.05）;2组TBil、ALT和HBV-DNA水平均低于治疗前,差异有统计学意义（P〈0.05）;治疗组死亡8例（12.3%）,对照组死亡17例（27.0%）,2组比较差异有统计学意义（P〈0.05）。结论核苷（酸）类似物抗病毒治疗慢性重型乙型肝炎3个月后,可以明显降低乙肝病毒DNA（HBV-DNA）水平,改善肝功能,降低病死率。

Effect observation of antiviral therapy with nucleoside(or nucleotide) analogues on chronic severe hepatitis B

Objective To evaluate the effect of antiviral therapy with nucleoside(or nucleotide) analogues on chronic severe hepatitis B.Methods 65 patients with chronic severe hepatitis B in treatment group were treated with nucleoside(or nucleotide) analogues besides medical comprehensive treatment,while 63 patients in control group were only treated with medical comprehensive treatment.Compare the total bilirubin(TBIL),alanine aminotransferase (ALT),prothrombin activity(PTA),the level of hepatitis B virus DNA(HBV-DNA) and fatality rate of 2 groups.Results After 1 month treatment,the PTA of 2 groups was higher than that before treatment,but there was no statistical significance between the 2 groups(P>0.05);The TBIL,ALT and the level of HBV-DNA of 2 groups were all lower than those before treatment,but there were no statistical significance between the 2 groups(P>0.05);6 patients died(9.2%) in treatment group,while 6 patients died(9.5%) in control group,so there was no statistical significance between the 2 groups(P>0.05).After 3 months treatment,the PTA of 2 groups was higher than that before treatment,and the PTA of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05);The The TBIL,ALT and the level of HBV-DNA of 2 groups were all lower than those before treatment,and the differences were statistically significant(P<0.05);8 patients died(12.3%) in treatment group,while 17 patients died(27.0%) in control group,and the difference was statistically significant(P<0.05).Conclusions After 3 months, treating chronic severe hepatitis B with nucleoside(or nucleotide) analogues,which can decrease the level of HBV-DNA obviously,improve liver function and decrease fatality rate .