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目的探讨恩替卡韦治疗失代偿期乙型肝炎肝硬化患者的临床效果。方法选取2014年1月至2015年1月青岛市城阳区第二人民医院收治的74例失代偿期乙型肝炎肝硬化患者作为研究对象,将其采用随机数字表法分为观察组与对照组,各37例。对照组患者给予常规护肝治疗,观察组患者在对照组基础上采用恩替卡韦进行治疗,检测两组患者治疗前,治疗12周、48周后丙氨酸转氨酶(ALT)、清蛋白(ALB)、总胆红素(TBIL)、凝血酶原时间(PT)、胆碱酯酶(CHE)、乙型肝炎病毒的脱氧核糖核酸(HBV-DNA)水平、Child-Pugh评分及透明质酸、层粘连蛋白、Ⅲ型前胶原、Ⅳ型胶原等肝纤维指标,并比较其乙型肝炎e抗原(HBe Ag)阴转率及HBe Ag/乙型肝炎e抗体(抗-HBe)血清学转换率。结果治疗12周、48周后,观察组患者ALT、TBIL、CHE、PT含量及Child-Pugh评分、HBV-DNA水平均明显低于对照组,ALB水平明显高于对照组,差异均有统计学意义(均P<0.05);且观察组患者的HBe Ag阴转及HBe Ag/抗-HBe血清学转换率均明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者的透明质酸、层粘连蛋白、Ⅲ型前胶原及Ⅳ型胶原均明显低于对照组,差异均有统计学意义(均P<0.05)。结论恩替卡韦治疗失代偿期乙型肝炎肝硬化可有效抑制病毒复制,改善患者肝功能,阻止肝纤维化形成。
Objective To investigate the clinical efficacy of entecavir in the treatment of decompensated hepatitis B cirrhosis. Methods Seventy-four patients with decompensated hepatitis B cirrhosis admitted from No. 2 People’s Hospital of Chengyang District, Qingdao City from January 2014 to January 2015 were selected as study subjects and divided into observation group and control group Control group, 37 cases each. Patients in the control group were treated with conventional liver protection. The patients in the observation group were treated with entecavir on the basis of the control group. ALT, ALB, (TBIL), prothrombin time (PT), cholinesterase (CHE), hepatitis B virus DNA level, Child-Pugh score, hyaluronic acid, Protein, type Ⅲ procollagen and type Ⅳ collagen. The seroconversion rates of HBeAg and HBe Ag / HBeAg were also compared. Results At 12 weeks and 48 weeks after treatment, ALT, TBIL, CHE, PT, Child-Pugh scores and HBV-DNA levels in observation group were significantly lower than those in control group and ALB levels were significantly higher than those in control group (All P <0.05). The seroconversion rates of HBe Ag and HBe Ag / anti-HBe in the observation group were significantly higher than those in the control group (all P <0.05). The observation group The levels of hyaluronic acid, laminin, type Ⅲ procollagen and type Ⅳ collagen in patients were significantly lower than those in control group (all P <0.05). Conclusion Entecavir treatment of decompensated hepatitis B cirrhosis can effectively inhibit viral replication, improve liver function and prevent the formation of hepatic fibrosis.