恩替卡韦对乙肝肝硬化代偿期乙肝病毒应答、肝功能水平的影响

目的：探讨恩替卡韦对乙肝肝硬化代偿期乙肝病毒应答、肝功能水平的影响。方法选择2012年1月至2015年9月我院收治的乙肝肝硬化代偿期患者74例，将其按照随机数字表法随机分为观察组和对照组，每组37例，对照组给予阿德福韦酯口服、观察组给予恩替卡韦片口服，比较两组患者治疗6个月后的临床疗效、病毒应答情况，以及治疗前后的肝功能、HBV DNA水平。结果观察组患者治疗总有效率为91.89%(34/37)，明显高于对照组的72.97%(27/37)，差异具有统计学意义(P<0.05)；治疗6个月后，观察组患者病毒完全应答15例、部分应答13例、无应答9例，对照组患者完全应答7例、部分应答12例、无应答18例，观察组病毒应答情况明显优于对照组，差异具有统计学意义(P<0.05)；治疗后两组患者谷丙转氨酶(ALT)、谷草转氨酶(AST)、AST水平均有所降低，且观察组降低程度明显优于对照组，差异均具有统计学意义(P<0.05)，而治疗前后两组患者的总胆红素(TBIL)水平均无明显变化(P>0.05)；治疗3个月和6个月后，两组患者HBV-DNA水平均显著降低，且观察组降低程度显著优于对照组，差异均具有统计学意义(P<0.05)。结论恩替卡韦治疗乙肝肝硬化代偿期患者具有着显著的临床疗效，其能够有效提高患者的病毒应答反应，有助于患者肝功能的改善并延缓病情的进展，值得临床推广运用。

Effect of entecavir on hepatitis B virus response and liver function level in patients with decompensated hepatitis B cirrhosis

Objective To investigate the effect of entecavir on hepatitis B virus response and liver function lev-el in patients with decompensated hepatitis B cirrhosis. Methods Seventy-four patients with decompensated hepatitis B cirrhosis were treated from January 2012 to September 2015 in our hospital, and randomly divided into observation group (n=37) and control group (n=37) according to the random number table. The control group was treated with oral adefovir dipivoxil, and the observation group was given oral entecavir tablets. The clinical efficacy and immune re-sponse after 6 months of treatment, as well as liver function and HBV-DNA levels before and after treatment were com-pared between the two groups. Results The total effective rate of observation group was significantly higher than that of the control group 91.89%(34/37) vs 72.97%(27/37), P<0.05]. After 6 months of treatment, there were 15 cases of complete response, 13 cases of partial response and 9 cases of no response in the observation group, and 7 cases of com-plete response, 12 cases of partial response and 18 cases of no response in the control group, with immune response in the observation group significantly better (P<0.05). After treatment, the alanine aminotransferase (ALT) and aspartate transaminase (AST) level in both groups were significantly decreased (P<0.05), and the decrease extents of observation group were significantly better than those of the control group (P<0.05), with no significant changes in total bilirubin (TBIL) level in both groups before and after treatment (P>0.05). The HBV-DNA level were significantly decreased in both groups after 3 months of treatment and 6 months of treatment, and the decrease extents of observation group were significantly better than those of the control group (P<0.05). Conclusion Entecavir treatment in patients with decom-pensated hepatitis B cirrhosis has a significantly clinical effect. It can effectively improve the viral response, which is helpful to improve the liver function and delay the progression of the disease. It is worthy to be popularized and applied.