恩替卡韋抗病毒治療乙型肝炎肝硬化失代償期的臨床價值

徐虹

[關鍵詞] 恩替卡韋;拉米夫定;抗病毒治療;乙型肝炎;肝硬化失代償期;肝功能

[中圖分類號] R512.62;R575.2? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）20-0025-03

The clinical value of entecavir antiviral treatment of hepatitis B with decompensated cirrhosis

XU Hong

Department of Infectious Diseases，the First People's Hospital of Xianning City in Hubei Province，Xianning? ?437000，China

[Abstract] Objective To explore the clinical value of entecavir antiviral treatment for hepatitis B with decompensated cirrhosis. Methods A total of 100 patients with decompensated hepatitis B liver cirrhosis diagnosed and treated in our hospital from January 2015 to January 2020 were selected as the research objects and equally divided into the observation group and the control group， with 50 cases in each group. The control group was treated with lamivudine， and the observation group was treated with entecavir. The liver function indexes， the negative conversion rate of HBV-DNA after 3 and 6 months of treatment， and the occurrence of adverse reactions were compared between the two groups. Results The TBIL， ALT and AST in the observation group were lower than those in the control group， ALB in the observation group was higher than that in the control group ，with significant difference（P<0.05）. The negative conversion rate of HBV-DNA in the observation group after three months and six months of treatment were higher than those in the control group， and the difference was statistically significant（P<0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups（P>0.05）. Conclusion Entecavir antiviral therapy in hepatitis B with decompensated cirrhosis can improve the liver function and curative effect of patients and has high safety， which is worthy of promotion.

[Key words] Entecavir; Lamivudine; Antiviral therapy; Hepatitis B; Decompensated cirrhosis; Liver function

在我國引起肝硬化的原因主要為病毒性肝炎，目前尚無有效治療方法逆轉肝硬化，肝硬化失代償期指的是該類肝病的終末期，治療主要以改善肝功能、去除病因、及時治療并發癥等為主。乙肝病毒持續復制是肝硬化病情進展的一個危險因素，如果不積極抗乙肝病毒治療，則病因無法去除，不能有效控制病情進展。在肝硬化失代償期會出現較多的并發癥，導致該時期患者疾病治療的難度增加，且在預后方面也較差[1]，所以乙肝肝硬化失代償期的治療一直是臨床治療方面的難題，近年來對乙肝抗病毒治療的藥物研究一直在進行，一般采用拉米夫定進行治療，可發揮一定的療效。依據研究及近些年來的臨床觀察，拉米夫定抗乙肝病毒治療3～5年后耐藥率高，而恩替卡韋抗乙肝病毒治療起效快、耐藥率低、副作用少，能夠發揮更為有效的療效，為了進一步研究乙肝肝硬化失代償期采用恩替卡韋抗病毒治療的臨床療效，本研究選擇2015年1月至2020年1月期間在我院診治的100例乙型肝炎肝硬化失代償期患者作為研究對象，并將恩替卡韋抗乙肝病毒治療與拉米夫定抗乙肝病毒治療進行對比研究，現報道如下。

1 資料與方法

1.1一般資料