恩替卡韦治疗慢性重型乙型肝炎疗效观察

目的观察恩替卡韦治疗慢性重型乙型肝炎的疗效。方法44例慢性重型乙型肝炎患者分为观察组与对照组,在综合性护肝治疗基础上,观察组22例口服恩替卡韦0.5 mg,每日1次;对照组22例口服拉米夫定100 mg,每日1次。疗程均3个月。观察患者病毒量、血清病毒标志物、生化学指标(ALT、TB IL、ALB、PTA)及病死率的改变。结果治疗3个月后观察组和对照组血清HBV-DNA含量较治疗前明显下降(t观察组=5.012 8,t对照组=4.906 0,P<0.01),而观察组较对照组下降更明显(t=2.339 7,P<0.05);治疗3个月后对照组ALT、TB IL较治疗前显著降低(tALT=10.858 9,tTB IL=8.560 5,P<0.01),ALB、PTA显著升高(tALB=6.197 5,tPTA=24.671 1,P<0.01);观察组ALT、TB IL较治疗前显著降低(tALT=12.636 6,tTB IL=9.166 4,P<0.01),ALB、PTA显著升高(tALB=8.921 5,tPTA=27.766 6,P<0.01);且观察组ALT、TB IL明显低于对照组(tALT=2.461 2,tTB IL=2.335 7,P<0.05),ALB、PTA明显高于对照组(tALB=2.520 1,P<0.05;tPTA=3.101 2,P<0.01)。治疗3个月后观察组和对照组HBeAg血清学转换率无显著差异(2χ=0.00,P>0.05),观察组病死率明显低于对照组(2χ=4.13,P<0.05)。结论恩替卡韦治疗慢性乙型重型肝炎优于拉米夫定。

Effect of entecavir in patients with chronic severe hepatitis B

Objective To observe the clinical effect of entecavir （ETV） in patients with chronic severe hepatitis B. Methods Forty -four patients with chronic severe hepatitis B were randomly divided into observation group and control group （n = 22）. Based on the comprehensive treatment, The patients in observation group were treated with entecavir 0.5 mg by mouth once a day. The patients in control group were treated with lamivudine 100 mg by mouth once a day,for three months. The serum HBV -DNA, HBVM, biochemical index and case fatality were investigated, Results After three months, serum HBV - DNA content in two groups was decreased significantly （t = 5. 012 8 ,t = 4. 906 0 ,P 〈 0.01 ）, while it dropped more significantly in observation group than this in control group （t = 2：339 7, P 〈 0.05 ）. In control group, compared with pretreatment, alanine aminotransferase（ALT） and total bilirubin（TBIL） were significantly lower（tALT = 10. 858 9 ,tTBIL = 8. 560 5 ,P 〈0.01 ）, and albumin （ALB） and prothrombin activity （PTA） were significantly higher after treatment （ t ALB = 6. 197 5, tPTA = 24. 671 1, P 〈 0. 01 ）. In observation group, compared with pretreatment, ALT and TBIL were significantly lower （ tALT = 12. 636 6, tTBIL = 9.166 4, P 〈 0.01 ）, and ALB and PTA were significantly higher after treatment （ tALB = 8.921 5, tPTA = 27. 766 6, P 〈 0.01 ）.After treatment, ALT and TBIL were significantly lower（ tALT =2. 461 20tTBIL 32. 335 7 ,P 〈0.05）, and ALB and PTA were significantly higher in observation group than those in control group （tALB =2. 520 1 ,P 〈 0.05 ;tPTA =3. 101 2;P 〈 0.01 ）. The case fatality rate was obviously lower in observation group than this in control group （χ^2 = 4.13, P 〈 0. 05 ）, but there was no significant difference in HbeAg serology conversion rate between two groups after treatment （χ^2 = 0. 00,P 〉 0. 05）. Conclusion Entecavir is superior to lamivudine on curing chronic viral hepatitis B.