恩替卡韦与替比夫定治疗child-pugh B级乙型肝炎肝硬化的疗效比较

目的观察恩替卡韦和替比夫定治疗child-pugh B级乙型肝炎肝硬化的疗效及安全性。方法将70例乙型肝炎肝硬化患者随机分为恩替卡韦组和替比夫定组,每组35例,以治疗48周为观察终点,分析两组疗效、病原学指标改变和不良反应。结果恩替卡韦组和替比夫定组分别有45.7%和37.1%的患者由child-pugh B级改善为child-pugh A级,但两组之间child-pugh评分差异无统计学意义。恩替卡韦组和替比夫定组患者血清HBV-DNA阴转率分别为91.4%和85.7%,HBeAg转换率分别是22.2%和28.6%,两组HBV-DNA阴转率和HBeAg转换率差异无统计学意义。结论恩替卡韦和替比夫定治疗乙型肝炎肝硬化安全有效。恩替卡韦组较替比夫定组不良反应少。

Therapeutic effects of entecavir and telbivudine on patients with Pugh grade B hepatitis B-induced Child cirrhosis of the liver

Objective To study the therapeutic effect and safety of entecavir and telbivudine on patients with hepatitis B in duced Child Pugh grade B cirrhosis of the liver. Methods Seventy patients with hepatitis B induced Child Pugh grade B cirrhosis of the liver were randomly divided into entecavir group and telbivudine group, 35 in each group. The patients were treated for 48 weeks before the therapeutic effect and data of etiology and adverse reactions of the patients were analyzed by laboratory diagnosis and molecu- lar biology. Results After 48 weeks＇ treatment , the child pugh scores and HBV DNA levels were lowered significantly in both groups （P 〈0.05）. 45.7% of the Child Pugh grade B patients improved to Child Pugh grade A in entecavir group,and 37.1% of Child Pugh grade B patients improved to Child Pugh grade A in telbivudine group. However, the child pugh scores and HBV DNA levels were not significantly different（P 〉0.05 ）. The rate of serum HBV -DNA negative conversion was 91.4% and 85.7% in the two groups, respectively. At 48 weeks, the rate of HBeAg seroconversion was 22.2% and 28.6% , but there was not statisticant differ ence between entecavir group and telbivudine group by chi square test （ P 〉 0.05）. Conclusions In child patients with repatitis B induced cirrhosis of the liver, entecavir and telbivudine are almost equally effective. Entecavir and telbivudine are safe and effective in treatment of patients with hepatitis B induced Child Pugh grade B cirrhosis of the liver.