恩替卡韦治疗肝功能衰竭的短期疗效观察

目的观察恩替卡韦治疗HBV相关肝功能衰竭的短期疗效。方法60例HBV相关肝功能衰竭患者分为ETV组、LAM组、未抗病毒治疗组（对照组）各20例，分别接受ETV、LAM治疗，对照组给予内科常规治疗。观察三组患者的MELD评分、病毒学指标及病死率的改变。结果三组患者12周存活率比较，差异无统计学意义；三组4周时MELD评分均值比较，差异无统计学意义；三组血清HBV DNA水平比较，差异无统计学意义。治疗期间无明显的副反应发生。结论NA抗病毒治疗可能延长肝衰竭患者12周生存率，为肝移植赢得时间；ETV通过强效迅速抑制病毒治疗肝衰竭疗效可能优于LAM；抗病毒治疗肝衰竭的评价及药物选择需扩大样本进一步研究。

Observation of efficacy and safety of enticavir in treatment of liver failure

Objective To evaluate the clinical efficacy and safety of enticavir(ETV) in treatment of liver failure.Methods A total of 60 patients were divided into enticavir or lamivudine(LAM) in treatment group consisted of 20 patients and treated with ETV or LAM plus inter medicine and control group consisted of 20 patients and treated only with inter medicine.The inter medicine of the three groups were nearly same.The levels of the HBVDNA,the MELD score and the mortality were compared.Results Compared with the control group,the levels of HBVDNA in ETV or LAM treatment group were not significantly decreased after treatment;and so were in the MELD Score and the morbility.No side effect was observed in the patients during treatment.Conclusion ETV is effective and safe in treatment of patients with acute on chronic hepatitis B.