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目的研究恩替卡韦治疗肝硬化失代偿期、代偿期及慢性乙型肝炎患者的疗效差异,为临床不同阶段肝硬化和慢性乙型肝炎患者的治疗提供正确指导。方法随机选取本院收治的肝硬化失代偿期患者20例、肝硬化代偿期患者18例及初治慢性乙型肝炎患者38例,三组患者均采用恩替卡韦进行抗病毒治疗,并随访观察。对三组患者治疗前后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乙型肝炎病毒e抗原(HBeAg)、HBV DNA定量、胆碱酯酶(CHE)、血清总胆红素(TBIL)、血清白蛋白(ALB)等指标的变化情况进行比较。结果三组患者各指标治疗前比较差异均无显著性(P>0.05)。治疗后三组患者ALT、AST、HBV DNA、TBIL水平均较治疗前明显下降,且治疗前后组内比较差异具有显著性(P<0.05);三组患者HBeAg、CHE、ALB水平与治疗前比较均明显上升,差异具有显著性(P<0.05);三组患者治疗后各指标比较差异均无显著性(P>0.05)。结论临床采用恩替卡韦治疗肝硬化失代偿期、代偿期及慢性乙型肝炎均具有较好的恢复肝功能、降低病毒载量的功效,且治疗各期肝硬化的疗效无显著差异。
Objective To study the efficacy of entecavir in the treatment of patients with decompensated and decompensated cirrhosis and chronic hepatitis B and to provide proper guidance for the treatment of patients with cirrhosis and chronic hepatitis B in different stages. Methods Twenty patients with decompensated liver cirrhosis, 18 patients with decompensated cirrhosis and 38 patients with newly diagnosed chronic hepatitis B were enrolled in this study randomly. Entecavir was used in all three groups for antiviral therapy and follow-up . The levels of ALT, AST, HBeAg, HBV DNA, cholinesterase (CHE), serum total bilirubin (TBIL), serum albumin (ALB) and other indicators of the changes were compared. Results There was no significant difference between the three groups before treatment (P> 0.05). The levels of ALT, AST, HBV DNA and TBIL in the three groups after treatment were significantly lower than those before treatment (P <0.05), and the levels of HBeAg, CHE and ALB in the three groups were significantly lower than those before treatment (P <0.05). There was no significant difference between the three groups after treatment (P> 0.05). Conclusion The clinical efficacy of entecavir in the treatment of decompensated liver cirrhosis, decompensated and chronic hepatitis B patients has better liver function and lower viral load. There is no significant difference between the two groups in the treatment of cirrhosis.