核苷类药物在乙型肝炎后肝硬化治疗中的应用与疗效

时间:2022-03-13 09:42:23 公文范文 来源:网友投稿

  [摘要] 目的 評价恩替卡韦(ETV)、替诺福韦(TDF)治疗乙型肝炎后肝硬化的临床疗效。方法 方便选取该院2016年1—6月收治的100例乙型肝炎后肝硬化患者随机分为A、B两组(各50例),A组给予ETV 0.5 mg/d,B组给予TDF300 mg/d,对比两组服药0、3、6、9、12个月的病毒载量情况、血清生化指标。结果 治疗3,6,9,12个月后HBV DNA数量均得到明显改善(P<0.05)、Child-Puch评分明显降低(P<0.05)、HBeAg转阴率明显升高(P<0.05)、ALT水平明显降低(P<0.05)。组间对比,治疗6、9、12个月后,B组患者的HBV DNA数量分别为(3.99±1.24)、(3.42±1.14)、(2.98±0.98)Log10拷贝/mL,明显低于恩替卡韦(ETV)治疗A组(P<0.05);治疗9、12个月后B组患者的Child-Puch评分分别为(7.2±1.4)分、(6.8±1.3)分,明显低于A组(P<0.05);HBeAg转阴率分别为26%、32%,显著高于A组(P<0.05);治疗6个月后B组患者的ALT水平为(54.34±18.64)μL,明显低于A组(P<0.05);经过12个月的治疗后,A组不良反应发生率(22%)显著高于B组(8%),差异有统计学意义(P<0.05)。结论 ETV、TDF核苷类药物治疗乙型肝炎后肝硬化临床疗效显著,且TDF效果优于ETV。
  [关键词] 核苷类药物;乙肝肝硬化;病毒载量情况;血清生化指标
  [中图分类号] R512 [文献标识码] A [文章编号] 1674-0742(2018)01(c)-0121-03
  [Abstract] Objective This paper tries to evaluate the clinical efficacy of entecavir (ETV) and tenofovir (TDF) in the treatment of post-hepatitis B cirrhosis. Methods 100 cases of hepatitis B of patients with liver cirrhosis in this hospital were treated from January 2016 to June 2016 were randomly divided into group A, B(each with 50 cases), group A was given ETV 0.5 mg/d, group B was given TDF300 mg/d, 0, 3, 6, 9, 12 months of viral load, serum biochemical indexes of the two groups were compared. Results After 3, 6, 9, 12 months treatment, HBV DNA were significantly improved(P<0.05), Child-Puch score was significantly lower (P<0.05), HBeAg negative rate was significantly increased(P<0.05), ALT levels were significantly lower(P<0.05); according to the comparison between the two groups, the number of 6, 9, 12 months after treatment of HBV DNA (TDF) treatment in group B was (3.99±1.24),(3.42±1.14), (2.98±0.98) Log10 copg/mL, significantly lower than that of entecavir(ETV) treatment in group A(P<0.05); group B of Child-Puch score 9, 12 months after treatment was (7.2±1.4)points,(6.8±1.3)points, lower than that of A group(P<0.05), the negative rate of HBeAg was 26% and 32%,significantly higher than that of group A(P<0.05); After 6 months of treatment, the ALT level of group B was(54.34±18.64)μL, significantly lower than that of group A(P<0.05); after 12 months of treatment, the incidence of adverse reactions in group A (22%) was significantly higher than that of group B(8%)(P<0.05), with statistical significance. Conclusion The clinical efficacy of ETV, TDF nucleoside drugs in the treatment of post-hepatitis B cirrhosis is significant, and TDF is better than ETV.
  [Key words] Nucleoside drugs; Hepatitis B cirrhosis; Viral load; Serum biochemical indicators

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