摘要
【目的】观察恩替卡韦治疗乙肝肝硬化患者48周疗效。【方法】60例乙肝肝硬化患者,给予恩替卡韦0.5 mg,1次/d口服,持续治疗48周。观察治疗前、治疗后12、24、36、48周病毒学、生化指标、凝血酶原活动度(PTA)及Child-Pugh积分等变化情况。【结果】患者血清HBV DNA对数值在治疗前为(6.76±1.80)log拷贝/ml,在接受恩替卡韦治疗后12、24、36、48周时分别下降至(3.00±0.66)log拷贝/ml(P<0.01)、(3.00±0.24)log拷贝/ml(P<0.01)、(3.00±0.11)log拷贝/ml(P<0.01)、(3.00±0.05)log拷贝/ml(P<0.01)。(治疗后HBV DNA检测不到的患者被定为999拷贝/ml)。在12、24、36和48周时分别有75%(45/60),95%(57/60),96.67%(58/60)和98.33%(59/60)的患者HBV DNA转阴。在治疗48周时,44.44%(12/27)的患者出现了HBeAg阴转,22.22%(6/27)的患者出现了HBeAg血清学转换。在治疗48周时丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)明显下降,白蛋白(Alb)、总胆红素(TBil)、前白蛋白(PAlb)、胆碱酯酶(CHE)、PTA及Child-Pugh积分等指标均有所改善(P<0.05)。【结论】恩替卡韦对于乙肝肝硬化的患者在48周内即能有效抑制病毒复制,使HBV DNA水平下降,同时可以改善肝功能、凝血酶原活动度及Child-Pugh积分等指标。
[Objective] To study the therapy effect of 48-week entecavir （ETV） treatment on cirrhosis of liver resulting from chronic hepatitis B. [Methods] A total of 60 patients received ETV 0.5mg orally everyday for 48 weeks. The changes were observed at the 12, 24, 36 and 48 weeks, including virological and biochemical markers, PTA and ChildPugh score. [Results] The mean of HBV DNA decreased from （6.76 ± 1.80） log copies/ml to （3.00 ± 0.66）, （3.00 ± 0.24）, （3.00±0.11）, （3.00±0.05） log copies/ml （P〈0.01） at 12, 24, 36, 48 weeks , respectively. The proportion of patients with HBV DNA undetectable was 75% （45/60） at 12 weeks, while it increased to 95% （57/60）, 96.67% （58/60） and 98.33% （59/60） at 24, 36, 48 weeks , respectively. At the end of 48 weeks, the HBeAg loss and the HBeAg/anti-HBe seroconversion rates were 44.44% （12/27） and 22.22% （6/27）, respectively. ALT , AST , albumin, total bilirubin, prealbumin, acetylcholine esterase, PTA and Child-Pugh score were improved at 48 weeks （ P 〈 0.05） than those of the pretreatment. [Conclusions] ETV can inhibit the replication of HBV in cirrhosis resulting from chronic hepatitis B after 48-week treatment, and reduce the level of HBV DNA , improve the liver function , PTA and Child-Pugh score.
出处
《武警医学院学报》
CAS
2008年第4期307-309,共3页
Acta Academiae Medicinae CPAPF
