CAJ | 학술논문

目的：研究恩替卡韦治疗肝硬化失代偿期、代偿期及慢性乙型肝炎患者的疗效差异，为临床不同阶段肝硬化和慢性乙型肝炎患者的治疗提供正确指导。方法随机选取本院收治的肝硬化失代偿期患者20例、肝硬化代偿期患者18例及初治慢性乙型肝炎患者38例，三组患者均采用恩替卡韦进行抗病毒治疗，并随访观察。对三组患者治疗前后丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、乙型肝炎病毒e抗原（HBeAg）、HBV DNA定量、胆碱酯酶（CHE）、血清总胆红素（TBIL）、血清白蛋白（ALB）等指标的变化情况进行比较。结果三组患者各指标治疗前比较差异均无显著性（P＞0.05）。治疗后三组患者ALT、AST、HBV DNA、TBIL水平均较治疗前明显下降，且治疗前后组内比较差异具有显著性（P＜0.05）；三组患者HBeAg、CHE、ALB水平与治疗前比较均明显上升，差异具有显著性（P＜0.05）；三组患者治疗后各指标比较差异均无显著性（P＞0.05）。结论临床采用恩替卡韦治疗肝硬化失代偿期、代偿期及慢性乙型肝炎均具有较好的恢复肝功能、降低病毒载量的功效，且治疗各期肝硬化的疗效无显著差异。
목적：연구은체잡위치료간경화실대상기、대상기급만성을형간염환자적료효차이，위림상불동계단간경화화만성을형간염환자적치료제공정학지도。방법수궤선취본원수치적간경화실대상기환자20례、간경화대상기환자18례급초치만성을형간염환자38례，삼조환자균채용은체잡위진행항병독치료，병수방관찰。대삼조환자치료전후병안산전안매（ALT）、천동안산전안매（AST）、을형간염병독e항원（HBeAg）、HBV DNA정량、담감지매（CHE）、혈청총담홍소（TBIL）、혈청백단백（ALB）등지표적변화정황진행비교。결과삼조환자각지표치료전비교차이균무현저성（P＞0.05）。치료후삼조환자ALT、AST、HBV DNA、TBIL수평균교치료전명현하강，차치료전후조내비교차이구유현저성（P＜0.05）；삼조환자HBeAg、CHE、ALB수평여치료전비교균명현상승，차이구유현저성（P＜0.05）；삼조환자치료후각지표비교차이균무현저성（P＞0.05）。결론림상채용은체잡위치료간경화실대상기、대상기급만성을형간염균구유교호적회복간공능、강저병독재량적공효，차치료각기간경화적료효무현저차이。
Objective To study entecavir decompensated cirrhosis and decompensated differences in the treatment of chronic hepatitis B patients, provide proper guidance for the clinical treatment of patients with hepatitis B cirrhosis and different stages. Method Randomly selected our hospital patients with decompensated cirrhosis 20 cases, 18 cases of patients with compensated cirrhosis and chronic hepatitis B patients with newly diagnosed 38 cases, three groups of patients were treated with entecavir antiviral treatment, and follow-up observation. Compared the changes of three groups of patients before and after treatment alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatitis B virus e antigen (HBeAg), HBV DNA quantitative, cholinesterase (CHE), serum total bilirubin (TBIL), serum albumin (ALB) and other indicators. Result Three groups of patients before treatment difference of indicators had no signiifcant (P>0.05). Before each indicator and treatment after treatment, ALT, AST, HBV DNA, TBIL levels showed a clear downward trend, and the difference between before and after treatment was signiifcant (P<0.05) in each group;HBeAg, CHE, ALB levels before treatment comparison showed a clear upward trend, the difference was signiifcant (P<0.05);after treatment three groups indexes showed no significant difference (P>0.05). Conclusion The clinical entecavir decompensated cirrhosis and decompensated chronic hepatitis B have better recovery of liver function, reduce viral load effect, and for the treatment of liver cirrhosis signiifcant difference.