Shu Xin, Xu Qi-huan, Chen Ni, Zhang Ka, Li Gang
Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2008 Dec;22(6):481-3.
To investigate the clinical features and the short-term efficacy of ETV treatment of 132 HBeAg negative and 51 HBeAg the HBeAg negative acute-on-chronic hepatitis B liver failure.
positive patients with acute-on-chronic liver failure were rolled. 84 patients were treated with ETV (0.5 mg daily) and routine supportive therapy. 99 patients in the control group received supportive therapy only. The clinical features and the short-term (180 days) efficacy of ETV were compared between the HBeAg negative and HBeAg positive groups.
The age of HBeAg negative patients was significantly higher (P = 0.001). The viral load was significantly higher in the HBeAg positive group (P = 0.001). There was no significant difference in the severity and the mortality in control group between the different HBeAg groups. In the antiviral treatment groups, 20/25 HBeAg positive patients survived and 32/59 HBeAg negative patients survived (P = 0.004). The mortality of HBeAg negative patients in control group was higher than that in treatment group (P = 0.032). In HBeAg negative patients with the HBV DNA <5 log copies/ml and HBV DNA >3 log copies/ml, 10/18 patients in treatment group survived and 6/30 patients in control group survived (P = 0.011).
There was no significant difference in the mortality between different HBeAg patients in routine treatment group. Antiviral therapy with ETV significantly improve survival rate in HBeAg negative patients. In patients with the HBeAg negative and HBV DNA <5 log copies/ml and >3 log copies/ml, antiviral therapy with ETV can improve the survival rate.
探讨恩替卡韦（ETV）治疗132例HBeAg阴性和51例HBeAg阳性慢性乙型肝炎急性肝衰竭患者的临床特征及短期疗效。
纳入HBeAg阳性和阴性慢性肝衰竭急性发作患者。84例患者接受ETV（每日0.5mg）及常规支持治疗。99例对照组患者仅接受支持治疗。比较HBeAg阴性和阳性组ETV的临床特征及短期（180天）疗效。
HBeAg阴性患者年龄显著更高（P = 0.001）。HBeAg阳性组病毒载量显著更高（P = 0.001）。不同HBeAg组对照组的严重程度和死亡率无显著差异。在抗病毒治疗组中，25例HBeAg阳性患者中有20例存活，59例HBeAg阴性患者中有32例存活（P = 0.004）。对照组中HBeAg阴性患者的死亡率高于治疗组（P = 0.032）。在HBV DNA<5 log拷贝/ml和HBV DNA>3 log拷贝/ml的HBeAg阴性患者中，治疗组18例患者中有10例存活，对照组30例患者中有6例存活（P = 0.011）。
常规治疗组不同HBeAg患者的死亡率无显著差异。ETV抗病毒治疗显著提高HBeAg阴性患者的生存率。在HBV DNA<5 log拷贝/ml且>3 log拷贝/ml的HBeAg阴性患者中，ETV抗病毒治疗可提高生存率。
