核苷类抗病毒药物治疗失代偿期乙肝肝硬化的临床疗效

郭强，赵凯 *

富平县医院内三科，陕西 渭南，711700

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摘要：

目的 分析阿德福韦酯、拉米夫定、恩替卡韦三种核苷类抗病毒药物治疗失代偿期乙肝肝硬化的临床疗效。方法 选取2014年 1月至 2016年 7月我院收治的 126例失代偿期乙型肝炎后肝硬化患者，随机分为 A、B、C 组，各 42例。A、B、C 三组分别接受阿德福韦酯、拉米夫定、恩替卡韦治疗，均治疗 1 年后，比较三组患者的肝功能改善情况、抗病毒治疗情况及不良反应情况。结果 治疗 1年后，三组患者的 ALT、AST 及 TBIL 水平均低于治疗前，且 C 组均低于 A、B 组（P<0.05）；C 组患者的 HBV DNA 载量下降幅度及 HBeAg转阴率明显优于 A、B 组，差异显著（P<0.05）。结论 对失代偿期乙肝肝硬化患者采用恩替卡韦治疗，能够明显改善患者的肝功能，有效降低病毒载量，提高 HBeAg转阴率，值得临床推广。

关键词：阿德福韦酯；拉米夫定；恩替卡韦；失代偿期；乙肝肝硬化

中图分类号：R657.3文献标志码：A文章编号：2096-1413(2018)09-0034-02

Clinical efficacy of nucleoside antiviral drugs in the treatment of
decompensated hepatitis B cirrhosis
 

GUO Qiang,ZHAO Kai *
(No.3 InternalMedicineDepartment,theHospitalofFupingCounty,W einan 711700,China)




ABSTRACT: Objective To analyze the clinical efficacy of three nucleoside antiviraldrugs which were adefovir dipivoxil,lamivudine and entecavir in the treatment of decompensated hepatitis B cirrhosis. Methods One hundred and twenty-six
patients with decompensated hepatitis B cirrhosis treated in our hospital from January 2014 to July 2016 were randomly divided into A, B and C groups,with 42 cases in each group. The three groups were treated with adefovir dipivoxil, lamivudine, entecavir respectively and were treated for one year, then the liver function improvement,anti-virus treatment effects and incidences of adversere actions in the three groups were compared. Results One year after treatment,the levels of ALT,AST and TBIL in the three groups were lower than those before treatment,and the levels in group C were lower than those in groups A and B (P<0.05).The decrease of HBV DNA load and the negative rate of HB eAgin group C were better than those in groups A and B (P<0.05). Conclusion Entecavir in the treatment of decompensated hepatitis B cirrhosiscan improve liver function, reduce viralload and increase then egativerate of HBeAg,which deserves clinical promotion.
KEYWORDS: adefovir dipivoxil; lamivudine;entecavir;decompensation;hepatitis B cirrhosis

参考文献：
[1] 张静雯,时永全,韩英.肝硬化的治疗进展 [J].临床肝胆病杂志 ,2015,31(3):465-468.
[2]LOK AS.Hepatitis:long-term therapy ofchronic hepatitisB reverses cirrhosis[J].NatRevGastroenterol& Hepatol,2013,10(4):199-200.
[3] 陈轶,陈益耀,韩向阳,等.乙型肝炎肝硬化失代偿期患者应用核苷类药物临床观察 [J].中国煤炭工业医学杂志 ,2016,19(7):948-951.
[4] 黄英男,吴昊,沈锡中.乙型肝炎肝硬化抗病毒治疗研究进展 [J]. 复旦学报:医学版 ,2013,40(2):233-238.
[5] 葛均波,徐永健.内科学 [M].8 版.北京:人民卫生出版社 ,2013:54.
[6] 周文兴,吕国良,刘馨.核苷类药物在乙型肝炎后肝硬化治疗中的疗效分析 [J].中国生化药物杂志 ,2012,33(2):170-172.
[7] 科技部 " 十二五 " 重大专项联合课题组.乙型肝炎病毒相关肝硬化的临床诊断、评估和抗病毒治疗的综合管理 ( 节选 )[J]. 中华医学信息导报 ,2015,30(1):16.
[8]YE XG,SU QM.Effects ofentecavir and lamivudine for hepatitis B decompensated cirrhosis:Meta-analysis[J].W orld J ofGastroenterol,2013,19(39):6665-6678.
[9] 连佳,韩涛,向慧玲,等.恩替卡韦与阿德福韦酯单药治疗慢性乙型肝炎相关性肝病患者 240 周的随机对照研究 [J]. 中华肝脏病杂志 ,2015,23(10):733-737.