论文部分内容阅读
目的探讨拉米夫定与恩替卡韦治疗慢性乙型病毒性肝炎慢加亚急性肝衰竭(SACLF)的临床疗效。方法回顾性分析2009年2月至2013年2月在福州市传染病院接受治疗的慢性乙型病毒性肝炎SACLF患者106例,按照实际用药分组,其中采用恩替卡韦治疗的慢性乙型病毒性肝炎慢加亚急性肝衰竭患者(研究组)53例,采用拉米夫定治疗的患者53例(对照组),比较恩替卡韦与拉米夫定治疗的临床疗效。结果研究组患者经治疗4、12、24周后,其HBV-DNA转阴率均明显高于对照组(χ2=4.63、6.01、11.84,P<0.05或P<0.01)。两组患者在治疗前肝功能指标比较无统计学差异(P均>0.05)。治疗后4、12、24周,两组患者的ALT、AST、TBIL较治疗前明显下降(P均<0.05),PTA则明显上升(P均<0.05);治疗后12、24周,ALB则明显上升(P均<0.05)。但两组间治疗后ALT、AST、TBIL、ALB、PTA水平比较差异无统计学意义(P均>0.05)。两组均未出现严重不良反应事件,亦无病情进展者。研究组2例开始治疗后轻度腹胀不适,对照组2例一过性皮疹,均经对症处理后消失。结论恩替卡韦治疗慢性乙型病毒性肝炎SACLF,HBVDNA转阴率较拉米夫定增高,但在改善肝功能和短期预后方面与拉米夫定无明显差别。
Objective To investigate the clinical efficacy of lamivudine and entecavir in the treatment of chronic and subacute liver failure (SACLF) in patients with chronic hepatitis B virus. Methods A total of 106 SACLF patients with chronic hepatitis B who were treated in Fuzhou Infectious Disease Hospital from February 2009 to February 2013 were retrospectively analyzed. According to the actual treatment group, chronic hepatitis B with entecavir was slowly added 53 patients with subacute hepatic failure (study group) and 53 patients treated with lamivudine (control group) were enrolled in this study. The clinical efficacy of entecavir and lamivudine was compared. Results After treatment for 4, 12, and 24 weeks, the HBV-DNA negative rate in the study group was significantly higher than that in the control group (χ2 = 4.63,6.01,11.84, P <0.05 or P <0.01). There was no significant difference between the two groups before treatment (P all> 0.05). At 4, 12 and 24 weeks after treatment, ALT, AST and TBIL in both groups were significantly lower than those before treatment (all P <0.05), PTA increased significantly (all P <0.05); at 12 and 24 weeks after treatment, ALB Significantly increased (all P <0.05). However, there was no significant difference in the levels of ALT, AST, TBIL, ALB and PTA between the two groups (all P> 0.05). No serious adverse events were reported in both groups and no progression was observed. Two patients in the study group had mild distension discomfort after starting treatment, and two patients had a transient rash in the control group, which disappeared after symptomatic treatment. Conclusion Entecavir treatment of chronic hepatitis B SACLF, HBVDNA negative rate than lamivudine increased, but in improving liver function and short-term prognosis and lamivudine no significant difference.