恩替卡韦抗病毒治疗乙型肝炎肝硬化失代偿期的临床价值

徐虹

[关键词] 恩替卡韦;拉米夫定;抗病毒治疗;乙型肝炎;肝硬化失代偿期;肝功能

[中图分类号] R512.62;R575.2          [文献标识码] A          [文章编号] 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为病毒性肝炎，目前尚无有效治疗方法逆转肝硬化，肝硬化失代偿期指的是该类肝病的终末期，治疗主要以改善肝功能、去除病因、及时治疗并发症等为主。乙肝病毒持续复制是肝硬化病情进展的一个危险因素，如果不积极抗乙肝病毒治疗，则病因无法去除，不能有效控制病情进展。在肝硬化失代偿期会出现较多的并发症，导致该时期患者疾病治疗的难度增加，且在预后方面也较差[1]，所以乙肝肝硬化失代偿期的治疗一直是临床治疗方面的难题，近年来对乙肝抗病毒治疗的药物研究一直在进行，一般采用拉米夫定进行治疗，可发挥一定的疗效。依据研究及近些年来的临床观察，拉米夫定抗乙肝病毒治疗3～5年后耐药率高，而恩替卡韦抗乙肝病毒治疗起效快、耐药率低、副作用少，能够发挥更为有效的疗效，为了进一步研究乙肝肝硬化失代偿期采用恩替卡韦抗病毒治疗的临床疗效，本研究选择2015年1月至2020年1月期间在我院诊治的100例乙型肝炎肝硬化失代偿期患者作为研究对象，并将恩替卡韦抗乙肝病毒治疗与拉米夫定抗乙肝病毒治疗进行对比研究，现报道如下。

1 资料与方法

1.1一般资料