摘要
目的探讨替诺福韦酯在乙型病毒性肝炎合并肝硬化患者挽救治疗中的应用效果。方法收集2014-2017年沈阳市第六人民医院收治的乙肝合并肝硬化拉夫米定抗病毒治疗失败的患者89例,以替诺福韦酯进行挽救治疗%周。分别依据挽救治疗前患者HBV定量和谷丙转氨酶(ALT)水平将患者进行分组,比较不同分组情况下HBV累积应答率、乙型肝炎E抗原(HBeAg)累积转换率和ALT累积复常率。结果本组89例患者中,HBV累积应答64例,占71.91%;HBeAg累积转换32例,占35.96%;ALT累积复常74例,占83.15%。低定量组与高定量组HBV累积应答率、HBeAg累积转换率、ALT累积复常率差异均有统计学意义(P值均<0.05)。低转氨酶组与高转氨酶组HBV累积应答率、HBeAg累积转换率、ALT累积复常率差异均无统计学意义(P值均>0.05)。结论替诺福韦酯作为挽救治疗用药,可有效抑制乙型肝炎病毒复制,改善转氨酶和肝炎抗体指标,尤其是对病毒定量水平较低的患者,效果更为明显。
Objective To investigate the application effect of tenofovir dipivoxil in rescue treatment of patients with hepatitis B complicated with cirrhosis.Methods From 2014 to 2017,a total of 89 patients with hepatitis B complicated with liver cirrhosis whofailed to receive anti viral therapy with lamivudine were collected and treated with tenofovir dipivoxil for 96 weeks.The patients were divided into groups according to HBV quantitative and alanine aminotransferase(ALT)levels before rescue treatment.The cumulative response rate of HBV,the cumulative conversion rate of hepatitis B cantigen(HBeAg)and the cumulative normalization rate of ALT in different groups were compared.Results Among the 89 cases,64 cases(71.91%)were HBV cumulative response,32 cases(35.96%)were HBeAg cumulative conversion,and 74 cases(83.15%)were ALT cum ulative norm alization.There were significant differences in HBV cumulative response rate,HBeAg cumulative conversion rate and ALT cumulative normalization rate between low dose group and high dose group(P<0.05).There was no significant difference in HBV cumulative response rate,HBeAg cumulative conversion rate and ALT cumulative normalization rate between low ALT group and high ALT group(P>0.05).Conclusion Tenofovir dipivoxil can effectively inhibit hepatitis B virus replication,improve transaminase level and hepatitis antibody indexes,especially for patients with low viral quantitative level.
作者
徐一铭
XU Yiming(Department of Pharmacy,Shenyang Sixth People's Hospital,Shenyang 110006,Liaoning Province,China)
出处
《中国实用乡村医生杂志》
2021年第3期61-64,共4页
Chinese Practical Journal of Rural Doctor
