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目的探讨恩替卡韦治疗乙肝后肝硬化失代偿期的临床疗效。方法 110例乙肝后肝硬化失代偿期患者作为研究对象,采用随机数字表法将所选患者分为研究组和对照组,各55例,对照组给予常规综合治疗和拉米夫定治疗,研究组在常规综合治疗的基础上给予恩替卡韦口服治疗,持续监测6个月,综合比较两组患者治疗前后总胆红素(TBil)、谷丙转氨酶(ALT)、白蛋白(ALB)的变化、乙肝病毒的脱氧核糖核酸(HBV-DNA)转阴率和病死率。结果治疗后研究组TBil、ALT均低于对照组(P<0.05),ALB高于对照组(P<0.05);研究组无死亡病例,HBV-DNA转阴率和病死率分别为87.3%和0,优于对照组的67.3%、16.4%(P<0.05)。结论恩替卡韦治疗乙肝后肝硬化失代偿期患者效果确切,可有效降低或延缓肝病进展,降低病死率,值得临床广泛推广使用。
Objective To investigate the clinical efficacy of entecavir in the treatment of decompensated liver cirrhosis after hepatitis B. Methods A total of 110 patients with decompensated hepatitis B after liver cirrhosis were enrolled in this study. The selected patients were divided into study group and control group by random number table method, 55 cases in each group. The control group was given conventional combined therapy and lamivudine therapy, The study group was treated with entecavir orally on the basis of routine comprehensive treatment and was continuously monitored for 6 months. The changes of total bilirubin (TBil), alanine aminotransferase (ALT) and albumin (ALB) before and after treatment were compared between the two groups. Hepatitis B virus DNA (HBV-DNA) negative rate and mortality. Results After treatment, the levels of TBil and ALT in the study group were lower than those in the control group (P <0.05), and those in the ALB group were significantly higher than those in the control group (P <0.05). No deaths were found in the study group. The rates of HBV-DNA negative conversion and mortality were 87.3% 0, which is superior to 67.3% and 16.4% of the control group (P <0.05). Conclusion Entecavir is effective in treating patients with decompensated liver cirrhosis after hepatitis B, which can effectively reduce or delay the progress of liver disease and reduce the mortality. It is worth widely used in clinic.