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恩替卡韦对乙型肝炎病毒相关性肝硬化患者的抗病毒作用

[Antiviral effects of entecavir in patients with hepatitis B virus-related cirrhosis].

作者信息

Xu Yan, Wang Jiang-bin, Xu Jie, Jiao Jian, Zhang Yong-gui, Ji Shang-wei, Zhao Ping, Guo Hong-hua, Li Yan, Zhou Chang-yu

机构信息

China-Japan Union Hospital of Jilin University, Changchun 130033, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2010 Feb;18(2):109-12. doi: 10.3760/cma.j.issn.1007-3418.2010.02.008.

Abstract

OBJECTIVE

To analyze antiviral effects of entecavir in patients with hepatitis B virus-related cirrhosis.

METHODS

104 patients of hepatitis B virus-related cirrhosis with no previous history of antiviral therapy were treated with entecavir 0.5 mg once daily. 37 patients were taken hepatic histologic examination before and after the treatment.

RESULTS

Mean reductions of serum HBV DNA was 5.1 log10 96 weeks after the treatment, HBV DNA became undetectable in 98.1% patients, and ALT became normal in 80.7% patients; HBeAg seroconversion occurred in 13.9% of the 72 HBeAg positive patients; 61.5% of these patients were infected with genotype C HBV, and 26.9% were infected with genotype B HBV. The genotype of HBV was not associated with the therapeutical effect. Child-pugh score was associated with the progression of the disease: the proportion of patients with disease progression was highest in Child-Pugh C grade patients and lowest in Child-Pugh A grade patients. The level of the HBV DNA load was positively correlated with Knodell HAI score at the baseline and 96 weeks after the treatment.

CONCLUSION

Entecavir treatment results in suppression of HBV replication and delayed progression of fibrosis in patients with hepatitis B virus-related cirrhosis.

摘要

目的

分析恩替卡韦对乙型肝炎病毒相关性肝硬化患者的抗病毒作用。

方法

104例既往无抗病毒治疗史的乙型肝炎病毒相关性肝硬化患者接受恩替卡韦治疗,每日一次,剂量为0.5mg。37例患者在治疗前后进行了肝脏组织学检查。

结果

治疗96周后,血清HBV DNA平均下降5.1 log10,98.1%的患者HBV DNA检测不到,80.7%的患者ALT恢复正常;72例HBeAg阳性患者中13.9%发生HBeAg血清学转换;这些患者中61.5%感染C基因型HBV,26.9%感染B基因型HBV。HBV基因型与治疗效果无关。Child-pugh评分与疾病进展相关:疾病进展患者比例在Child-Pugh C级患者中最高,在Child-Pugh A级患者中最低。HBV DNA载量水平与基线及治疗96周后的Knodell HAI评分呈正相关。

结论

恩替卡韦治疗可抑制乙型肝炎病毒相关性肝硬化患者的HBV复制并延缓纤维化进展。

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