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目的:评价恩替卡韦对初期治疗代偿期和失代偿期乙肝肝硬化患者抗病毒的疗效。方法:选取2014年9月—2015年9月间收治的代偿期和失代偿期乙肝肝硬化患者85例;将其分为恩替卡韦初治代偿期组(45例)和失代偿期组(40例);比较两组患者治疗前后AST、ALT、TBi L、ALB以及CHE等指标变化情况。结果:治疗后代偿组患者ALT为(35.33±5.89)U/L,AST为(41.29±15.29)U/L,TBi L为(21.34±11.87)μmol/L;而失代偿组患者分别为(74.03±10.97)U/L,(97.21±20.08)U/L和(49.04±12.65)μmol/L(P<0.05);治疗后代偿组患者ALB为(44.21±5.31)g/L,CHE为(5 445.98±762.19)U/L,失代偿组分别为(31.23±3.09)g/L和(3 219.03±983.21)U/L(P<0.05);代偿组治疗后ChildPugh评分值为(5.17±1.02)分和HBV-DNA阴转率为91.11%优于失代偿组为(8.97±1.03)分和HBV-DNA阴转率为82.50%(P<0.05)。结论:采用恩替卡韦初治乙肝肝硬化患者,其代偿期的疗效优于失代偿组。
OBJECTIVE: To evaluate the efficacy of entecavir in antiviral treatment of patients with decompensated and decompensated hepatitis B cirrhosis. Methods: Totally 85 patients with decompensated and decompensated hepatitis B cirrhosis were enrolled from September 2014 to September 2015. They were divided into entecavir initial decompensation group (n = 45) and decompensated (N = 40). The changes of AST, ALT, TBiL, ALB and CHE before and after treatment were compared between the two groups. Results: After treatment, the ALT in the compensated group was (35.33 ± 5.89) U / L, the AST was (41.29 ± 15.29) U / L and the TBi L was (21.34 ± 11.87) μmol / L; (74.03 ± 10.97) U / L, (97.21 ± 20.08) U / L and (49.04 ± 12.65) μmol / L respectively. The ALB in the compensated group was (44.21 ± 5.31) g / (3142 ± 3.09) g / L and (3 219.03 ± 983.21) U / L, respectively (P <0.05). The score of ChildPugh in the decompensated group was (5 445.98 ± 762.19) U / (5.17 ± 1.02), HBV DNA negative conversion rate (91.11%) and decompensation group (8.97 ± 1.03) and HBV DNA negative conversion rate (82.50%, P <0.05). Conclusion: The effect of compensatory phase of entecavir-treated hepatitis B cirrhosis patients is better than that of decompensated patients.