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目的分析失代偿期乙型肝炎肝硬化治疗中替比夫定的应用效果及安全性。方法 94例失代偿期乙型肝炎肝硬化患者,采用随机字母表法分为观察组与对照组,各47例。对照组患者采用常规治疗,观察组患者在常规治疗基础上采用替比夫定治疗。对比两组患者肝功能指标、病毒学指标转阴情况、生存率及不良反应情况。结果治疗前,两组患者的血清总胆红素(TBIL)、白蛋白(ALB)、丙氨酸转氨酶(ALT)比较,差异均无统计学意义(P>0.05);治疗后均较治疗前改善,且观察组改善程度优于对照组,差异均具有统计学意义(P<0.05)。观察组患者中有3例乙型肝炎e抗原(HBe Ag)阴转,有6例HBe Ag/乙型肝炎e抗体(HBe Ab)血清转换;7例死亡,生存40例,生存率为85.11%;对照组患者中无病情好转症状;16例死亡,生存31例,生存率为65.96%;观察组患者生存率明显高于对照组,差异具有统计学意义(χ~2=4.663,P<0.05)。观察组患者不良反应发生率17.02%与对照组10.64%对比,差异无统计学意义(P>0.05)。结论失代偿期乙型肝炎肝硬化治疗中应用替比夫定可明显改善肝功能,缓解病情,提高生存率,且未明显增加不良反应。
Objective To analyze the effect and safety of telbivudine in the treatment of decompensated hepatitis B cirrhosis. Methods Ninety-four patients with decompensated hepatitis B cirrhosis were randomly divided into observation group and control group with 47 cases in each group. Patients in the control group were treated with conventional therapy. Patients in the observation group were treated with telbivudine on the basis of routine treatment. Comparing the two groups of patients with liver function indicators, negative virological indicators, survival and adverse reactions. Results Before treatment, there was no significant difference in serum total bilirubin (TBIL), albumin (ALB) and alanine aminotransferase (ALT) between the two groups (P> 0.05) Improve, and the observation group improved better than the control group, the difference was statistically significant (P <0.05). In the observation group, 3 cases of hepatitis B e antigen (HBeAg) were negative and 6 cases of HBeAg / HBeA were seroconverted; 7 died and 40 survived, with a survival rate of 85.11% ; In the control group, there was no improvement of symptoms; 16 patients died and 31 patients survived, with a survival rate of 65.96%. The survival rate in the observation group was significantly higher than that in the control group (χ ~ 2 = 4.663, P <0.05 ). The incidence of adverse reactions in the observation group was 17.02% compared with that in the control group (10.64%), with no significant difference (P> 0.05). Conclusion The application of telbivudine in the treatment of decompensated hepatitis B cirrhosis can significantly improve liver function, relieve the disease and improve the survival rate, and did not significantly increase the adverse reactions.