本文選題：乙型肝炎　切入點：慢加急性肝功能衰竭　出處：《成都醫(yī)學院學報》2016年01期 　論文類型：期刊論文

【摘要】：目的對比拉米夫定和恩替卡韋在治療慢性乙型肝炎合并慢加急性肝衰竭方面的療效和安全性。方法將62例慢性乙型肝炎慢加急性肝衰竭患者隨機分為拉米夫定治療組(LAM組)和恩替卡韋治療組(ETV組),每組各31例。除常規(guī)內科綜合治療外,LAM組口服拉米夫定(LAM)100mg,1次/d;ETV組口服恩替卡韋(ETV)500mg,1次/d。對比兩組治療前后血清丙氨酸氨基轉移酶(ALT)、白蛋白(Alb)、總膽紅素(TBil)、凝血酶原活動度(PTA)及病毒學指標變化,并采用終末期肝病模型(MELD)評估兩組患者病情改善情況。結果 24周時LAM組生存率為77.4%(24/31),低于ETV組的87.1%(27/31),差異無統(tǒng)計學意義(P0.05)。兩組治療后12周、24周時ALT和TBil均明顯下降(P0.05或P0.01),Alb和PTA均明顯上升(P0.05或P0.01),但兩組間比較,差異無統(tǒng)計學意義(P0.05)。治療后12周、24周時兩組MELD評分和HBV DNA定量均明顯下降(P0.05或P0.01);治療后24周時,ETV組MELD評分低于LAM組(P0.01),ETV組HBV DNA轉陰率高于LAM組,差異有統(tǒng)計學意義(P0.05)。結論短期內LAM和ETV均能改善慢性乙型肝炎慢加急性肝功能衰竭患者的肝功能和病毒學指標,ETV較LAM對HBV病毒抑制效果更為明顯。
[Abstract]:Objective to compare the efficacy and safety of lamivudine and entecavir in the treatment of chronic hepatitis B complicated with chronic and acute hepatic failure. Methods Sixty-two patients with chronic hepatitis B and acute hepatic failure were randomly divided into lamivudine and lamivudine. Lam group (n = 31) and ETV group (n = 31). Lamivudine lamivudine 100 mg / g oral in lamivudine 100 mg / g / d / d in lamivudine group (ETV group) and entecavir treatment group (n = 31). Serum alanine amino-transfer was compared before and after treatment in the ETV group. Serum alanine amino transfer was compared between the two groups before and after treatment. The changes of ALT, Alb, Tbilirn, PTAA and virological indexes were observed. Results at 24 weeks after treatment, the survival rate of the LAM group was 77.4%, which was lower than that of the ETV group (87.1% / 31%). There was no significant difference between the two groups (P 0.05). The ALT and TBil of the two groups decreased significantly from 12 weeks to 24 weeks after treatment. Both P0.01Alb and P0.01Alb and PTA increased significantly (P0.05 or P0.01A), but there were significant differences between the two groups. There was no significant difference between the two groups (P 0.05). The MELD score and HBV DNA quantity in the two groups decreased significantly at 12 weeks and 24 weeks after treatment, and the MELD scores in the ETV group were lower than those in the LAM group and the HBV DNA negative rate in the LAM group was higher than that in the LAM group at 24 weeks after treatment. Conclusion both LAM and ETV can improve liver function and virology in patients with chronic hepatitis B and acute hepatic failure in a short period of time. ETV is more effective than LAM in inhibiting HBV virus.
【作者單位】： 廣西桂東人民醫(yī)院藥學部;廣西桂東人民醫(yī)院感染性疾病科;
【基金】：中國高校醫(yī)學期刊臨床專項資金(No:11524324)
【分類號】：R512.62;R575.3
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本文編號：1601257