恩替卡韦治疗乙肝肝硬化失代偿期的疗效和安全性分析

目的：评价恩替卡韦治疗乙肝肝硬化失代偿期的临床疗效及安全性。方法选取2010年5月-2013年4月该院收治的90例乙肝肝硬化失代偿期患者，随机分为观察组和对照组，其中对照组45例，给予还原型谷胱甘肽、促肝细胞生长素及甘草酸二胺等综合性护肝、保肝治疗，观察组45例，在对照组综合治疗的基础上给予恩替卡韦治疗，疗程6个月，观察并比较两组患者治疗前后肝功能指标变化、治疗前后Child-Pugh评分情况及不良反应的发生率。结果治疗6个月后，两组患者TBiL、ALT及AST的值均较治疗前有所改善，同组治疗前后相比差异有统计学意义（P＜0.05），观察组治疗后TBiL、ALT及AST改善程度相比于对照组治疗后差异有统计学意义（P＜0.05）；观察组治疗前后 Child-Pugh 评分分别为（8.50±1.51）分、（6.08±0.91）分，对照组治疗前后Child-Pugh评分分别为（8.31±1.68）分、（4.19±1.04）分，两组治疗后评分均有所降低，观察组降低程度更为明显，相比较差异有统计学意义（P＜0.05）。结论在综合治疗措施的基础上给予恩替卡韦治疗乙肝肝硬化失代偿期疗效好，安全性高，值得在临床上予以推广。

Analysis of the Efficacy and Safety of Entecavir in the Treatment of De-compensated Hepatitis B Cirrhosis

Objective To evaluate the clinical efficacy and safety of entecavir in the treatment of hepatitis B patients with decom-pensated cirrhosis. Methods 90 cases of hepatitis B patients with decompensated cirrhosis admitted in our hospital from May 2010 to April 2013 were selected and randomly divided into the observation group and the control group. 45 cases in the control group were given reduced glutathione, hepatocyte growth-promoting factors and diammonium glycyrrhizinate and other comprehensive liver protection treatment. 45 cases in the observation group were given entecavir on the basis of the comprehensive treatment of the control group. The course of treatment was 6 months. The changes of hepatic function indexes, Child-Pugh scores before and after treatment and the incidence of adverse reactions of two groups of patients were observed and compared. Results After 6 months of treatment, the values of TBiL, ALT and AST of both groups were improved compared with those before treatment, the difference in the values of TBiL, ALT and AST of the observation group or the control group before and after treatment was statisti-cally significant （P〈0.05）. After treatment, the difference in improvement degree of TBiL, ALT and AST between the observation group and the control group was statistically significant （P〈0.05）;before treatment, the Child-Pugh score of the observation group was （8.50±1.51） points, and that of the control group was （8.31±1.68） points, after treatment, the Child-Pugh score of the observa-tion group was （6.08±0.91） points, and that of the control group was （4.19±1.04） points, the Child-Pugh score of both groups was decreased after treatment, and that of the observation group was decreased more significantly, the difference was statistically sig-nificant by comparison, P〈0.05. Conclusion The efficacy of entecavir given to the hepatitis B patients with decompensated cirrho-sis on the basis of comprehensive treatment is good with high safety, which is deserved to be pr