摘要
目的观察替比夫定治疗失代偿期HBV DNA阳性的乙型肝炎肝硬化的长期疗效和安全性。方法将55例失代偿期乙型肝炎肝硬化患者随机分成2组,观察组28例:在常规保肝对症治疗的同时加用替比夫定600mg/d口服;对照组27例:采用常规保肝对症治疗,疗程均为104周。观察比较两组患者治疗前后临床表现、生化指标、病毒学、Child-Pugh计分改变情况、病死率。结果治疗104周,观察组71.4%(20/28)、对照组48.1%(13/27)(P<0.05)患者治疗后病情缓解稳定,肝功能好转或恢复正常;观察组患者HBV DNA水平显著下降,4、12、26、52、104周分别有46.4%(13/28)、64.3%(18/28)、71.4%(20/28)、75.0%(21/28)、75.0%(21/28)在检测水平以下(<500拷贝/ml),对照组患者HBV DNA水平没有显著下降,均可检测出。观察组Child-Pugh计分下降,由治疗前(10.5±0.7)降至(5.9±0.5),对照组由治疗前(10.4±0.8)降至(8.7±0.4),两组差异有统计学意义(P<0.05);104周观察组病死率17.9%(5/28),对照组37.0%(10/27),两组差异有统计学意义(P<0.01)。结论替比夫定治疗伴有病毒复制的失代偿期乙型肝炎肝硬化,能显著抑制病毒复制、改善肝功能,减缓病情发展,提高生存率,并且安全性好。
Objective To assess the efficacy and safety of telbivudine therapy on HBV DNA positive decompensated hepatitis B cirrhosis patients.Methods A total of 55 patients with decompensated hepatitis B cirrhosis were randomly divided into 2 groups.Treatment group of 28 cases：liver protection treatment plus telbivudine 600 mg/d orally and control group of 27 cases：conventional Liver protection treatment.Both the patient and the control groups were followed for 104 weeks.Clinical,biochemical,virological indexes Child-Pugh score and mortality were compared before and after treatment.Results After 104 weeks of treatment,the rate of symptomic and liver function remission were 71.4%（20/28） and 48.1%（13/27）（P 0.05） in the treatment and control groups respectively.The HBV DNA levels in the treatment group were significantly decreased.The negative rate of HBV DNA（ 500 copies/ml） at 4,12,26,52 and 104 weeks were 46.4%（13/28）,64.3%（18/28）,71.4%（20/28）,75.0%（21/28） and 75.0%（21/28）,respectively in the treatment groups.However,there was no significant difference between the treatment and the control group.Treatment group Child Pugh score decreased from（10.5 ± 0.7） to（5.9 ± 0.5） ;and in the control group Child-Pugh score decreased from（10.4 ±0.8） to（8.7 ±0.4）.There was a significant difference between the two groups（P 0.05）.The mortality rate after 104-week of treatment were 17.9%（5 /28） and 37.0%（10 /27） in the treatment and control group respectively（P 0.01）.Conclusion Telbivudine could significantly inhibit viral replication,improve liver function,slow disease progression,improve survival,and good security in decompensated hepatitis B cirrhosis patients with viral replication.
出处
《临床肝胆病杂志》
CAS
2010年第6期605-607,共3页
Journal of Clinical Hepatology
关键词
肝炎
乙型
肝硬化
替比夫定
hepatitis B
liver cirrhosis
Telbivudine
