恩替卡韦治疗乙肝失代偿肝硬化疗效及安全性研究

郭锐，邓宇，郭玲

（陕西省延安市人民医院消化内科，陕西 延安，716000）

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摘要：

目的 评价恩替卡韦治疗乙肝失代偿肝硬化的疗效和安全性。方法 将110例乙肝失代偿肝硬化患者随机分为试验组和对照组，每组55例。试验组给予恩替卡韦片治疗，对照组给予替比夫定片治疗。疗程均为24周。比较两组患者的血清 HBV-DNA完全抑制率、ALT 复常率、HBeAg 转阴率和肝功能（血清总胆红素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶），并观察两组患者不良反应发生情况。结果 治疗后，两组患者的T-BIL、ALT 和AST 均显著低于治疗前，且试验组低于对照组，差异均有统计学意义（P<0.05）；治疗后，试验组患者的血清HBV-DNA 完全抑制率、ALT复常率、HBeAg 转阴率显著优于对照组（P<0.05)；两组患者不良反应总发生率比较，差异无统计学意义（P>0.05)。结论 恩替卡韦治疗乙肝失代偿肝硬化的疗 效优于替比夫定，且未增加不良反应发生率。

关键词：乙肝失代偿肝硬化；恩替卡韦；替比夫定

中图分类号：R512.62;R575.2 文献标志码：A文章编号：2096-1413(2017)26-0032-02

Clinical effect and safety of entecavir in the treatment of Hepatitis B decompensated cirrhosis
GUO Rui, DENG Yu, GUO Ling
(Department of Gastroenterology, Yan``an People``s Hospital, Yan``an 716000, China)

ABSTRACT: Objective To assess the clinical effect and safety of entecavir in the treatment of Hepatitis B decompensated cirrhosis. Methods A total of 110 Hepatitis B decompensated cirrhosis patients were randomly divided into experimental group and control group, with 55 cases in each group. Patients in the experimental group were received entecavir treatment, while patients in the control group were received telbivudine treatment. The serum HBV-DNA completely inhibited rate, ALT normalization rate, HBeAg negative conversion ratio, and liver function (TBIL, ALT and AST) were compared in the two groups, and the incidence of complications were observed. Results After treatment, the T-BIL, ALT and AST in the two groups significantly decreased, and those in the experimental group were lower than the control group (P<0.05). After treatment, the serum HBV-DNA completely inhibited rate, ALT normalization rate, HBeAg negative conversion ratio in the experimental group were better than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusions The entecavir is more effective than telbivudine in the treatment of Hepatitis B cirrhosis, without increaseing the incidence of adverse events.
KEYWORDS: hepatitis B cirrhosis; entecavir; telbivudine

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