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目的观察分析替比夫定和恩替卡韦治疗代偿期乙肝肝硬化患者48周的疗效。方法 80例代偿期乙肝肝硬化患者,随机分为甲、乙两组,甲组患者采用替比夫定治疗,乙组患者采用恩替卡韦治疗,其余保肝治疗措施相同,均治疗48周,治疗结束后对比两组患者的临床疗效。结果治疗48周后两组患者肝功能较治疗前均显著改善,其中,谷丙转氨酶(ALT)、谷草转氨酶(AST)改善最显著,比较差异有统计学意义(P<0.05)。治疗48周后乙组HBV-DNA转阴率97.5%,显著优于甲组HBV-DNA转阴率77.5%,组间比较差异有统计学意义(P<0.05)。乙肝血清标志物乙肝e抗原(HBe Ag)转阴率甲组37.5%,乙组的40.0%,组间比较差异无统计学意义(P>0.05)。乙肝血清标志物乙型肝炎E抗体(HBe Ab)转阳率甲组12.5%,乙组的16.0%,组间比较差异无统计学意义(P>0.05)。结论恩替卡韦较替比夫定对代偿期乙肝肝硬化HBV-DNA复制抑制效果更好,病毒转阴率较高,两种药物均能促进乙肝血清标志物HBe Ag阴转,两组患者肝功能均显著改善,肝脏纤维化活动明显减轻,两组对比安全性均较好,无明显差异。
Objective To observe and analyze the efficacy of telbivudine and entecavir in the treatment of patients with decompensated hepatitis B cirrhosis for 48 weeks. Methods Eighty patients with decompensated hepatitis B cirrhosis were randomly divided into two groups. Patients in group A were treated with telbivudine, while patients in group B were treated with entecavir. The rest of the treatments were the same, both for 48 weeks. After comparing the clinical efficacy of two groups of patients. Results After 48 weeks of treatment, the liver function of both groups was significantly improved compared with that before treatment. Among them, ALT and AST showed the most significant improvement (P <0.05). After 48 weeks of treatment, HBV-DNA negative rate in group B was 97.5%, which was significantly better than that in group A (77.5%). There was significant difference between the two groups (P <0.05). Hepatitis B e antigen (HBeAg) negative rate of 37.5% in Group A, 40.0% in Group B, there was no significant difference between the two groups (P> 0.05). Serum markers of hepatitis B hepatitis B E antibody (HBe Ab) positive rate of 12.5% in group A, 16.0% in group B, there was no significant difference between the two groups (P> 0.05). Conclusion Entecavir was more effective than telbivudine in inhibiting HBV-DNA replication in patients with decompensated hepatitis B cirrhosis, and the virus negative conversion rate was higher. Both drugs could promote the HBeAg negative conversion of serum hepatitis B, and liver function Were significantly improved, liver fibrosis significantly reduced the safety of the two groups were better, no significant difference.