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目的探讨恩替卡韦对慢性重型乙型肝炎的抗病毒治疗疗效。方法选择80例慢性重型乙型肝炎患者,分为对照组和治疗组各40例;对照组给常规综合治疗,治疗组在常规综合治疗的基础上,加用恩替卡韦0.5mg,每日1次口服,观察疗程为48周;观察2组乙肝病毒DNA定量(HBV DNA)变化、肝功能的恢复及e抗原/e抗体血清转换的情况。结果在治疗12周时,治疗组检测丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)、总胆红素(TbiL)、白蛋白(ALB)、凝血酶原活动度(PTA)、e抗原、HBV DNA平均值分别为54.06,67.52,39.63,35.45,62.08,24.34,06.43;对照组分别为76.86,95.67,89.02,31.56,42.89,32.24,21.12;2组各项指标差异有统计学意义(P<0.05),表明治疗组优于对照组;在治疗24周时,治疗组检测ALT,AST,TbiL,ALB,PTA,e抗原,HBV DNA平均值分别为50.06,65.02,38.97,36.45,65.08,4.67,2.40;对照组分别为70.86,80.52,67.02,33.06,45.76,30.78,10.12;2组各项指标差异有统计学意义(P<0.05);治疗组和对照组死亡率分别为2.5%和22.5%,表明治疗组明显优于对照组;在治疗48周时,治疗组检测ALT,AST,TbiL,ALB,PTA,e抗原,HBV DNA平均值分别为40.58,54.23,38.07,38.43,70.18,3.57,0;对照组分别为56.67,75.52,69.09,33.98,59.86,24.86,14.12;2组各项指标差异有统计学意义(P<0.05);治疗组和对照组死亡率分别为5%和32.5%,表明治疗组优于对照组。结论恩替卡韦治疗慢性重型乙型病毒性肝炎是有效和安全的,可作为抢救慢性重型乙型肝炎的抗病毒治疗药物之一。
Objective To investigate the efficacy of entecavir in the treatment of chronic severe hepatitis B virus. Methods Eighty patients with chronic severe hepatitis B were divided into the control group and the treatment group, 40 cases in each group. The control group was given conventional comprehensive treatment. On the basis of conventional comprehensive treatment, the treatment group was treated with entecavir 0.5 mg orally once daily The course of treatment was 48 weeks. The changes of HBV DNA, the recovery of liver function and the seroconversion of e antigen / e antibody in two groups were observed. Results In the treatment group, the ALT, AST, TbiL, ALB, prothrombin activity ( PTA), e antigen and HBV DNA were 54.06,67.52,39.63,35.45,62.08,24.34,06.43 respectively; the control group were 76.86,95.67,89.02,31.56,42.89,32.24,21.12 respectively; (P <0.05), which showed that the treatment group was superior to the control group. At 24 weeks of treatment, the mean ALT, AST, TbiL, ALB, PTA and e antigen in the treatment group were 50.06 and 65.02, 38.97,36.45,65.08,4.67,2.40; the control group were respectively 70.86,80.52,67.02,33.06,45.76,30.78,10.12; the difference between the two groups was statistically significant (P <0.05); the treatment group and the control group died The rates of ALT, AST, TbiL, ALB, PTA and e antigen in the treatment group were 48.58 and 54.23, respectively. The mean HBV DNA levels in the treatment group were 40.58 and 54.23, 38.07,38.43,70.18,3.57,0 respectively; the control group were respectively 56.67,75.52,69.09,33.98,59.86,24.86,14.12; There was significant difference between the two groups (P <0.05); the death of the treatment group and the control group Rates were 5% and 32.5%, respectively, Ming treatment group than the control group. Conclusion Entecavir is effective and safe in the treatment of chronic severe hepatitis B and can be used as one of the antiviral drugs in the treatment of chronic severe hepatitis B.