恩替卡韦治疗失代偿期乙型肝炎肝硬化48周疗效观察

目的 观察恩替卡韦治疗失代偿期乙型肝炎肝硬化48周的疗效。方法 96例失代偿期乙型肝炎肝硬化患者被随机分为治疗组48例和对照组48例，其中治疗组给予恩替卡韦治疗48周。观察治疗前、治疗后24周和48周时的病毒学、生化学指标的变化情况。结果 患者在接受恩替卡韦治疗后24周和48周时血清HBV DNA水平小于1000 copies／ml比率分别为73．9％（34／46）和85．7％（36／42），与对照组比较差别有显著性意义（P值分别等于0．009和0．004）；血清丙氨酸氨基转移酶复常率分别为84．8％（39146）和88．0％（37／42），高于对照组的52．5％（21140）和44．1％（15／34），差别有显著性意义（P值均为0．000）；Child-Pugh计分分别为8．42±2．78和8．92±2．76，较治疗前明显下降，也比对照组的10．75±3．14和11．41±2．69明显降低（P值分别为0．018和0．044）。结论 恩替卡韦治疗乙型肝炎肝硬化患者能有效地抑制病毒复制，降低HBV DNA水平，同时可以改善肝功能及Child-Pugh计分等指标。

Study on 48-week treatment of entecavir in patients with decompensated hepatitis B-induced cirrhosis

Objective TO study the efficacy and safety of entecavir in patients with decompensated hepatitis B cirrhosis for 48 weeks. Methods Ninety six patients with decompensated hepatitis B cirrhosis were randomized to receive entecavir （n=48） or conventional therapy （n=48） for 48 weeks. The changes were observed at 24 th and 48th week,including virological and biochemical markers. Results The HBV DNA less rates were 73.9% at week 24 and 85.7% at week 48,the normal ALT rates were 84.8% and 88.0%,much higher than that in control group（P〈0.01）;Child＇Pugh score was lower than in pretreatment and in control group（P〈0.05）. Conclusions Entecavir can inhibit the replication of HBV in cirrhosis resulting from chronic hepatitis B,and reduce the level of HBV DNA,improve the liver function,and decrease the Child-Pugh score.