恩替卡韦与阿德福韦酯对HBeAg阳性乙肝肝硬化失代偿期患者肝功能影响.docVIP

恩替卡韦与阿德福韦酯对HBeAg阳性乙肝肝硬化失代偿期患者肝功能影响 　　[摘要] 目的 对比恩替卡韦与阿德福韦酯对HBeAg阳性乙肝肝硬化患者肝功能的影响。方法 方便选取2015年1月―2016年6月该院收治的HBeAg阳性失代偿期乙肝肝硬化患者85例作为研究对象，根据治疗方案的差异将其分为恩替卡韦组与阿德福韦酯组，两组患者治疗前人口学特征、肝功能状况、病毒学资料比较差异无统计学意义，其中阿德福韦酯组40例患者应用阿德福韦酯治疗，恩替卡韦组45例患者应用恩替卡韦治疗，比较两组患者治疗效果及治疗后肝功能变化情况。结果 两组患者治疗后ALT复常率及HBeAg转阴率比较（10.00%vs13.33%，72.50%vs71.11%），差异无统计学意义（P0.05），治疗后恩替卡韦组TBIL、Child-Pugh评分、HBV DNA阴转率明显优于阿德福韦酯组，差异有统计学意义（P0.05），两组患者治疗期间未见明显药物不良反应及肾功能变化。结论 恩替卡韦与阿德福韦酯治疗乙型病毒性肝炎失代偿性肝硬化均具有良好的疗效，但恩替卡韦对患者肝功能的改善效果更为显著，临床可结合患者实际病情选择恰当的药物治疗方案以提升临床治疗效果。 　　[关键词]恩替卡韦；阿德福韦酯；HBeAg阳性； 乙肝肝硬化；失代偿期；临床疗效 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2017）03（b）-0043-03 　　[Abstract] Objective To compare the effect of entecavir and adefovir dipivoxil on the liver function of patients with HBeAg positive cirrhosis after hepatitis B. Methods 85 cases of patients with HBeAg positive cirrhosis after hepatitis B admitted and treated in our hospital from January 2015 to June 2016 were selected and divided into two groups according to the different treatment plans， and there were no obvious differences in the demographic characteristics， liver function condition and virus data， and the adefovir dipivoxil （40 cases） were treated with adefovir dipivoxil， while the entecavir group （45 cases） were treated with entecavir， and the treatment effect and changes of liver function after treatment were compared between the two groups. Results After treatment， the differences in the ALT recovery rate and HBeAg seroconversion rate between the two groups had no statistical significance（10.00% vs 13.33%，72.50% vs 71.11%）（P0.05）， after treatment， the TBIL， Child-Pugh score and HBV DNA seroconversion rate in the entecavir group were obviously better than those in the adefovir dipivoxil group（P0.05）， and there were no obvious drug adverse reactions and renal function changes during the treatment period. Conclusion Both entecavir and adefovir dipivoxil in treatment of cirrhosis after hepatitis B have a better curative effect， but the improvement eff