替比夫定治疗乙型肝炎肝硬化的临床疗效和安全性分析

向海霞

（陕西省柞水县人民医院，陕西 商洛，711400）

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摘要：

目的 探讨替比夫定治疗乙型肝炎肝硬化的临床疗效和安全性。方法 选择2014年1月至2016年1月50例乙型肝炎肝硬化患者，均在保肝、抗肝纤维化及对症支持等综合治疗的基础上加用替比夫定口服（600 mg/次，1次/d），连续治疗16周，观察患者肝功能、肝纤维化指标的变化情况及不良反应。结果 与治疗前比较，患者治疗后8、12、16周的ALT、AST、TBil显著降低，而Alb、胆碱酯酶显著升高；同时，HA、LN、IV-C、PⅢP显著降低，差异有统计学意义（P<0.05）。患者HBV-DNA 转阴率为88.0%，HBeAg转阴率为14.0%。患者不良反应发生率为14.0%，给予对症治疗后均缓解。结论替比夫定治疗乙型肝炎肝硬化的临床疗效较好，安全性较高，但仍需大样本、多中心的进一步研究。

关键词：替比夫定；乙型肝炎肝硬化；安全性

中图分类号：R575.2文献标志码：A文章编号：2096-1413(2017)14-0020-02

Clinical efficacy and security analysis of telbivudine in the treatment of hepatitis B cirrhosis
XIANG Hai-xia
(Zhashui County People`s Hospital, Shangluo 711400, China)

ABSTRACT: Objective To discuss the clinical efficacy and security analysis of telbivudine in the treatment of hepatitis B cirrhosis. Methods A total of 50 cases of patients with hepatitis B cirrhosis admitted in our hospital from January 2014 to January 2016 performed the comprehensive treatment of protecting liver, resisting liver fibrosis and other expectant treatment. On this basis, they were given oral telbivudine (600 mg/times, 1 time/d). The process of treatment was 16 weeks, and the liver function, liver fibrosis indexes, and the complication of patients were observed. Results The ALT、AST、TBil in8th, 12th and 16th week after the treatment were significant lower than those before the treatment, while Alb and cholinesterase were significant increased; and the HA、LN、IV -C、PⅢP were decreased, the difference was statistically significant (P<0.05). The negative conversion ratio of HBV-DNA was 88.0%, while HBeAg was 14.0%. The incidence of adverse complication was 14.0% , and these cases relieved after symptomatic treatment. Conclusion Application of telbivudine in the treatment of hepatitis B cirrhosis was effective and safe, however, it required to perform further study with larger sample and more multicenter.
KEYWORDS: telbivudine; hepatitis B cirrhosis; security

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