CAJ | 학술논문

目的评估恩替卡韦(ETV)治疗慢性重型乙型肝炎的疗效及安全性.方法选择78例HBV DNA阳性慢性重型乙型肝炎分为ETV治疗组、对照组各39例.ETV组采用与对照组相同的内科综合治疗,并予ETC抗病毒治疗.检测两组肝功能、PTA、HBV DNA载量变化,记录不良事件.于第12周比较两组治疗有效率,并对ETV组有效与无效病例的基线情况进行比较分析.结果 ETV组、对照组的基线特征相似.12周时ETV组治疗有效率56.41%,对照组33.33%(P=0.0405).重肝早期患者中,ETV组治疗有效率明显高于对照组(P=0.0275),而中、晚期无明显差异(P=0.4687).ETV治疗有效与无效病例的基线比较结果显示:两组间年龄、胆红素、HBV DNA载量以及病情分期、肝硬化比例差异有统计学意义(P<0.05);而胆碱酯酶、甲胎蛋白水平及性别、腹水、HBeAg阳性比例差异无统计学意义(P>0.05).ETV治疗期间,无明显不良反应发生.结论 ETV在慢性重型乙型肝炎早期应用可以提高疗效,但对中期和晚期的疗效可能没有影响.其疗效可能与年龄、重肝分期、岛焖厮健BV DNA载量、是否合并肝硬化有关.ETV治疗慢性重型乙型肝炎有较好的安全性.
목적 평고은체잡위(ETV)치료만성중형을형간염적료효급안전성.방법 선택78례HBV DNA양성만성중형을형간염분위ETV치료조、대조조각39례.ETV조채용여대조조상동적내과종합치료,병여ETC항병독치료.검측량조간공능、PTA、HBV DNA재량변화,기록불량사건.우제12주비교량조치료유효솔,병대ETV조유효여무효병례적기선정황진행비교분석.결과 ETV조、대조조적기선특정상사.12주시ETV조치료유효솔56.41%,대조조33.33%(P=0.0405).중간조기환자중,ETV조치료유효솔명현고우대조조(P=0.0275),이중、만기무명현차이(P=0.4687).ETV치료유효여무효병례적기선비교결과현시:량조간년령、담홍소、HBV DNA재량이급병정분기、간경화비례차이유통계학의의(P<0.05);이담감지매、갑태단백수평급성별、복수、HBeAg양성비례차이무통계학의의(P>0.05).ETV치료기간,무명현불량반응발생.결론 ETV재만성중형을형간염조기응용가이제고료효,단대중기화만기적료효가능몰유영향.기료효가능여년령、중간분기、도민시건BV DNA재량、시부합병간경화유관.ETV치료만성중형을형간염유교호적안전성.
Objective To evaluate the efficacy and safety of entecavir(ETV)treatment for chronic severe hepatitis B. Methods 78 patients with chronic severe hepatitis B and positive HBV DNA were divided into ETV group and control group, each group had 39 patients. ETV group was given the same conventional therapy as control group,and was treated with ETV. The change of liver function, PTA, HBV DNA level were observed, and adverse events were recorded. The effective rate of treatment between ETV group and control group, the baseline characteristics between the effective cases and non-responsive cases after ETV treatment were compared at week 12.Results The basehne characteristics were well balanced between ETV group and control group.The effective rate of ETV group was 56.41% versus 33.33% of control group at week 12( P = 0.0405).The effective rate of ETV group was higher than that of control group,in the early stage of chronic severe hepatitis B( P = 0.0275) ,but there was no statistically significant in the middle or late stage( P = 0.4687) .The comparison result of baseline characteristics between the effective and non-responsive cases after ETV treatment showed: there were statistically different in age, bihrubin level, HBV DNA level and stage of the severe hepatitis, proportion of cirrhosis, but no statistically different in chohnesterase level, α- fetoprotein level and sex ratio, the proportion of ascites, positive HBeAg ( P > 0.05). No serious adverse events occurred. Conclusions ETV improves the curative effect when used in the early stage of chronic severe hepatitis B, and may not in the middle and late stage. The curative effect of ETV may be affected by age, bilirubin level, HBV DNA level and stage of the severe hepatitis, cirrhosis. ETV has good security in the treatment for chronic severe hepatitis B.