核苷酸类似物治疗HBeAg阳性或HBeAg阴性失代偿期肝硬化的临床疗效观察

发布时间：2018-04-05 12:03

本文选题：恩替卡韦　切入点：拉米夫定　出处：《新疆医科大学》2014年硕士论文

【摘要】：目的：探讨恩替卡韦(ETV)与拉米夫定(LAM)分别治疗HBeAg阳性或HBeAg阴性肝硬化失代偿期(Decompensated Liver Cirrhosis of hepatitis B virus DLC)患者的临床疗效。方法：回顾性分析收集2010年1月至2013年12月就诊于新疆医科大学感染性疾病中心的59例Chi1d-Pugh分级B-C级乙肝肝硬化失代偿期患者在综合治疗的基础上,分别分为恩替卡韦组30例(给予恩替卡韦片0.5mg一天一次空腹服用)和拉米夫定组29例(给予拉米夫定片100mg一天一次口服)。分别检测两组患者在治疗前及治疗后24周、48周血清乙肝病毒定量(HBV DNA)、HBeAg、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、凝血酶原活动度(PTA%)和Child-Pugh-Turcotte (CPT)评分等指标。结果：恩替卡韦组与拉米夫定组均能有效改善病情,比较差异有统计学意义(P0.05),但两组组间临床疗效相似,疗效比较差异无统计学意义(P0.05)。拉米夫定组治疗48周时有2例患者出现病毒学突破,恩替卡韦组无1例发生病毒学突破。结论：恩替卡韦或拉米夫定治疗HBeAg阳性或HBeAg阴性肝硬化失代偿期1年疗效相似,但1年治疗过程中恩替卡韦无发生病毒学突破,是乙肝失代偿期肝硬化抗病毒治疗的有效药物。
[Abstract]:Objective: to investigate the clinical effect of HBeAg positive or HBeAg negative Liver Cirrhosis of hepatitis B virus DLCL treated with entecavir and lamivudine respectively.Methods: 59 patients with Chi1d-Pugh grade B-C liver cirrhosis decompensated from January 2010 to December 2013 were retrospectively analyzed.The patients were divided into two groups: 30 cases of entecavir group (treated with 0.5mg once a day on an empty stomach) and 29 cases of lamivudine group (treated with lamivudine 100mg once a day).Results: both entecavir group and lamivudine group could effectively improve the condition, the difference was statistically significant (P 0.05), but the clinical efficacy was similar between the two groups, and there was no significant difference between the two groups (P 0.05).Two patients in lamivudine group had virological breakthrough at 48 weeks, but none in entecavir group.Conclusion: the efficacy of entecavir or lamivudine in the decompensation period of cirrhosis with HBeAg positive or HBeAg negative is similar in one year, but there is no virological breakthrough in the course of one year treatment, so it is an effective drug for antiviral treatment of hepatitis B decompensated cirrhosis.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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