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1、恩替卡韦治疗失代偿期乙型肝炎肝硬化的疗效观察杨静朱育王河（南昌大学第一附属医院消化科，南昌336000）通信作者：朱萱E-mailjyyfyzx@163.com摘要目的观察恩替卡韦治疗失代偿期乙型肝炎肝硬化患者48周的安全性和疗效。方法80例患者随机分为恩替卡韦（ETV）组和对照组各40例，疗程48周，观察治疗前、后生化指标、Child-Pugh评分、HBV1DNA标志物及HBVDNA。结果治疗4周时,ETV组HBVDNA下降幅度、HBVDNA不可测率、ALT复常率分别为2.261gIU/ml、50.0%、30.0%,均分别高于对照组（7
2、K0.05）。且随着疗程延长，均逐渐升高，在12、24、48周吋，ETV组IIBVDNA下降幅度、HBVDNA不可测率、ALT复常率均分别高于对照组（只0.05）。ETV组24、48周HBeAg阴转率均高于对照组（/M.560,7^0.033；X=7.892,住0.005）；治疗24、48周时,ETV组HBeAg血清学转换率与对照组比较,差异均无统计学意义（x-0.950,P=0.330；x~3.206,P0.073）。ETV组Child-Pugh分级均明显改善，ChildA级患者比例增加，高于对照组（x-26.898,/K0.05）,E
3、TV组出现疾病进展的比例低于对照组（/二8.352,/KO.05）o恩替卡韦组ALT.TBTL、HBVDNA、Child-Pugh评分下降，分别低于对照组（F均＞0.05）；ALB、PTA上升,分别高于对照组（卩均＜0.05）o48周内ETV组无耐药发生。结论ETV治疗失代偿期乙肝肝硬化能强效、快速抑制HBVDNA复制，改善Ch订d-Pugh分级和肝功能，延缓病情进展，耐药率低，耐受性好。关键词：恩替卡韦；肝炎，乙型，慢性AntiviraleffectsofentecavirinpatientswithhepatitisBvirus-in
4、duceddecompensatedlivercirrhosisYANGJing,ZHUXuan,WANGHe.(DepartmentofGastroenterology,TheFirstAffiliatedHospitalofNanchangUniversity,Nanchang336000,China)Abstract:ObjectiveToanalyseantiviraleffectsofentecavir(ETV)inpatientswithHBV-induceddecompensatedcirrhosis.Methods80ca
5、seswererandomlydividedintoentecavirgroupm=40)andcontrolgroup(n=40)for48weeks.HBVDNA,liverfunctionandChild-Pughscoreswereobservedatdifferenttimepoints.ResultsAtweek4,mean作者简介：杨静，女，硕士，副主任医师，主要从事消化系统疾病的临床与基础研究通信作者：朱萱，电话：（0791）8692505,E-mail：jyyfyzx@163.comreductionofHBVDNAwa
6、s2.26lgIU/ml,50.0%ofthepatientsachievedundetectableHBVDNAand30.0%achievedALTnormalizationinETVgroup.Atweek4,12,24,4&thedifferencesofmeanreductionofHBVDNA,undetectableHBVDNAandALTnormalizationwerestatiscallysignificantbetweenthetwogroups,respectively.ThedifferenceofHBeAgne
7、gativeconversionratesatweek24,48weresignificantandtheHBeAgseroconversionatweek24,48werenosignificantbetweenthetwogroups.ThedifferencesoftheimprovementofChild-PughscoresandthemeanlevelofALT,TBIL,HBVDNA,ALB,PTAandChild-PughscoreswerestatisticallysignificantbetweenETVgroupan
8、dcontrolgroup,respectively.ConclusionEntecavirtreatmentresultsinsuppressionofHBVreplicationandim
