恩替卡韦治疗慢性乙型肝炎和乙肝肝硬化高胆红素血症58例临床疗效观察

摘要

目的探讨恩替卡韦对治疗慢性乙型肝炎和乙肝肝硬化高胆红素血症的临床疗效。方法采用回顾性的方法对我院从2010年至2012年住院部诊治的慢性乙型肝炎及乙肝肝硬化合并高胆红素血症患者的临床资料进行回顾分析，从中选取了58例有相对可比性的病例，进行研究。这58例住院的患者，均存在肝功异常（胆红素升高3倍以上）及HBV-DNA升高（≥104IU/ml）。入院后全部都给予了常规的护肝疗法。其中一些经济条件好的患者，加用了恩替卡韦进行抗病毒治疗。我们可以分之为治疗组和对照组，其中治疗组有31例，对照组有27例。治疗1个月后（未停药），分别观察并记录两组患者的症状及试验室结果变化。主要包括HBV-DNA、肾功能、肝功能、凝血酶活跃度以及其它的一些不良反应。结果通过治疗后，病人的HBV-DNA有明显变化，其中治疗组在4周的治疗以后，有27例的HBV-DNA值＜104IU/ml，剩余4例也下降到了104IU/ml；而对照组只有4例是＜104IU/ml的，其余的24例和治疗前相比，均未出现变化。而患者的凝血酶活跃度、ALT和总胆红素等指标都有所好转，两组的差异显著为P＜0.05。在病情的发展方面，在治疗组的31例中，通过临床治疗1个月，共有29例病人肝功能明显好转。出现了1例重症肝炎患者，和2例并发症（腹水，腹腔感染）患者，经对症处理后缓解。无死亡病例。而在对照组的27例中，共有20例病人肝功能明显好转。有4例出现肝损害加重，和3例出现并发症患者。结论恩替卡韦对治疗慢性乙型肝炎和乙肝肝硬化高胆红素血症患者具有较好的临床疗效，值得推荐。%　　Objective To study well for Cave in the treatment of chronic hepatitis B and hepatitis B cirrhosis hyperbilirubinemia clinical curative effect. Methods the clinical data of the patients with chronic hepatitis B and hepatitis B cirrhosis complicated by hyperbilirubinemia patients diagnosis and treatment method of inpatients in our hospital from 2010 to 2012 were analyzed retrospectively review, selected from 58 cases with relatively comparable cases, research. The 58 cases of hospitalized patients, there were abnormal liver function (bilirubin increased more than 3 times) and elevated HBV-DNA (≥ 104IU/ml). After admission all given conventional liver therapy. Some of the good economic conditions of the patients, with the grace of antiviral treatment for Cave.We can be divided into the treatment group and the control group, the treatment group 31 cases, control group 27 cases. After 1 months of treatment (without stopping), were observed and recorded chamber results symptoms and test group two patients change.Including HBV-DNA, renal function, liver function, prothrombin activity and some other adverse reactions. Results after treatment, patients have obvious changes in HBV-DNA, The treatment group after 4 weeks of treatment, 27 cases of HBV-DNA < 104IU/ml, the remaining 4 cases also dropped to 104IU/ml; While the control group only 4 cases is < 104IU/ml, compared to 24 patients and treat the remaining before, did not change. While patients with thrombin activity, ALT and total bilirubin and other indicators have improved, differences between the two groups was signifcantly as P < 0.05. In the aspect of the development of the illness, in 31 cases of treatment group, treatment for 1 months by clinic, a total of 29 patients with liver function was improved. There were 4 cases of liver damage, and 3 cases appeared complications. Conclusion: for Cave on the treatment of chronic hepatitis B and hepatitis B cirrhosis hyperbilirubinemia patients with good clinical effcacy, worthy of recommendation.