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目的:评价恩替卡韦治疗慢性乙型重型病毒性肝炎的临床疗效。方法:45例患者在常规治疗的基础上给予恩替卡韦0.5mg,每日1次口服;另47例给予拉米夫定100mg,每日1次口服,存活患者的治疗时间不少于6个月。结果:恩替卡韦组临床疗效总有效率为80.0%,显著高于拉米夫定组总有效率66.0%(P<0.05);总胆红素(TBIL)和谷丙转氨酶(ALT)分别由治疗前的378.2±36.3umol/L和546.8±56.5 U/L降至146.5±35.4μmol/L和46.5±21.5U/L,凝血酶原活动度(PTA)由治疗前的32.5±5.8%升至59.5±16.8%,均较拉米夫定组改善明显(P<0.05);恩替卡韦组的HBeAg和HBV-DNA转阴率分别为71.4和66.7%,明显高于拉米夫定组的47.6%和45.2%(P<0.05)。病死率分别为6.7%和10.6%,无显著性差异(P>0.05)。结论:恩替卡韦治疗慢性乙型重型肝炎患者在临床疗效、肝功能改善和抑制病毒复制方面均优于拉米夫定治疗者。
Objective: To evaluate the clinical efficacy of entecavir in the treatment of chronic type B severe viral hepatitis. Methods: Forty-five patients received entecavir 0.5 mg daily for oral administration on the basis of conventional treatment. The other 47 patients were given lamivudine 100 mg orally once daily for at least 6 months. Results: The total effective rate of entecavir group was 80.0%, significantly higher than that of lamivudine group (66.0%, P <0.05). Total bilirubin (TBIL) and alanine aminotransferase (ALT) (P <0.05). The prothrombin activity (PTA) increased from 32.5 ± 5.8% before treatment to 59.5 ± 37.5 ± 35.4μmol / L and 46.5 ± 21.5U / L from 378.2 ± 36.3umol / L and 546.8 ± 56.5U / (P <0.05). The negative rates of HBeAg and HBV-DNA in entecavir group were 71.4% and 66.7% respectively, which were significantly higher than those in lamivudine group (47.6% and 45.2%, respectively) (P <0.05). Mortality rates were 6.7% and 10.6%, respectively, with no significant difference (P> 0.05). Conclusion: Entecavir is superior to lamivudine in the treatment of patients with chronic severe hepatitis B in clinical efficacy, improvement of liver function and suppression of virus replication.