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目的通过探究恩替卡韦与拉米夫定对失代偿期乙型肝炎肝硬化患者的治疗,探究两种药物对病人的安全性及疗效。方法选取2014年9月至2016年3月于上海市闵行区中心医院就诊的失代偿期乙型肝炎肝硬化患者80例,其中恩替卡韦40例、拉米夫定40例,记录病毒学应答率,HBV-DNA阴转率(HBV-DNA低于检测下限),血清学应答率,HBV-DNA均值水平及相关生化学指标变化,血清蛋白,血清胆碱酯酶及各种凝血因子的变化,24周时的临床疗效。结果两组在24周时,病毒学应答率,HBV-DNA阴转率,血清学应答率明显的上升,其差异无统计学意义(P>0.05)。恩替卡韦组生化学应答率比拉米夫定组高,其差异有统计学意义(P<0.05)。HBV-DNA均值水平及相关生化学指标呈现明显下降趋势,其差异有统计学意义(P<0.05)。在治疗过程中血清蛋白(ALB),血清胆碱酯酶(CHE)及各种凝血因子(PTA)水平均呈上升趋势,差异有统计学意义(P<0.05)。结论恩替卡韦与拉米夫定在乙型肝炎肝硬化患者的治疗过程中都有很好的疗效,经过各方面的综合比较,恩替卡韦的疗效要优于拉米夫定。
Objective To explore the safety and efficacy of two drugs on patients by investigating the treatment of patients with decompensated hepatitis B cirrhosis by entecavir and lamivudine. Methods Eighty patients with decompensated hepatitis B cirrhosis from September 2014 to March 2016 in Central Hospital of Minhang District of Shanghai were enrolled, of whom 40 entecavir and 40 lamivudine. The virological response rate , HBV-DNA negative rate (HBV-DNA below detection limit), serological response rate, HBV-DNA mean level and related biochemical indicators, serum protein, serum cholinesterase and various coagulation factors, 24 weeks of clinical efficacy. Results At 24 weeks, the virological response rate, HBV-DNA negative rate and serological response rate increased significantly in both groups, with no significant difference (P> 0.05). The biochemical response rate of entecavir group was higher than that of lamivudine group, with significant difference (P <0.05). HBV-DNA mean level and related biochemical indicators showed a significant downward trend, the difference was statistically significant (P <0.05). Serum protein (ALB), serum cholinesterase (CHE) and various coagulation factors (PTA) levels showed an upward trend during the treatment, the difference was statistically significant (P <0.05). Conclusion Entecavir and lamivudine have a good effect in the treatment of patients with liver cirrhosis. After all aspects of the comprehensive comparison, the efficacy of entecavir is better than lamivudine.