门冬氨酸鸟氨酸联合恩替卡韦治疗乙型重型肝炎的疗效观察

目的 观察门冬氨酸鸟氨酸联合恩替卡韦治疗乙型重型肝炎的临床疗效.方法 选择乙型重型肝炎病人63例,随机分成两组.对照组采用综合治疗,治疗组在对照组的基础上加用门冬氨酸鸟氨酸和恩替卡韦,两组疗程均为1个月,观察治疗前后临床、生物化学、病毒学指标变化.结果 (1)治疗组血清总胆红素(TBIL)和血清谷丙转氨酶(ALT)明显下降,TBIL下降较对照组更显著(P<0.05);(2)凝血酶原活动度(PTA)、白蛋白(ALB)增加较对照组显著(P<0.05);(3)HBV-DNA阴转率和负荷载量下降较对照组明显(P<0.01);(4)治疗组病死率明显低于对照组(P<0.01).结论 门冬氨酸鸟氨酸联合恩替卡韦治疗重型肝炎可使临床症状、体征、肝功能有明显改善,抑制HBV复制,提高生存率.

Observation of therapeutic effects of etecavir combined with L-ornithine-L-aspartate on severe hepatitis B

Objective To observe the clinical effects of etecavir combined with L-ornithine-L-aspartate therapy on severe hepatitis B.Methods 63 patients with severe hepatitis B were enrolled and randomized into therapeutic group(n=32) and control group(n=31).The therapeutic group was given entecavir 0.5mg daily combined with L-ornithine-L-aspartate 10g intravenous infusion daily;the control group was only given the same combined therapy as the therapeutic group while without being given etecavir and L-ornithine-L-aspartate for 1 month.Efficacy was assessed by clinic biochemical and virologic parameters.Results(1) After 1 month treatment there was obviously decreasing in TBIL and ALT,especially,the TBIL decreasing in therapeutic group were higher than those in control group(P<0.05).(2) PTA and albumin increasing in the therapeutic group were higher than those in control group(P<0.05).(3) HBV-DNA negative zero-conversion rate and loading volume decreasing in the therapeutic group were more higher than in control group(P<0.01)(4) Fatality rates in the therapeutic group was lower than in control group(P<0.01).Conclusion preliminary data indicates that etacavir with L-ornithine-L-aspartate therapy on severe hepatitis B can significantly improve clinical symptoms,signs and liver function,at the same time,it can effectively inhibit HBV replication and improve survival rate.