失代偿期肝硬化患者的乙型肝炎治疗。
Treatment of hepatitis B in decompensated liver cirrhosis.
作者信息
Guan Richard, Lui Hock Foong
机构信息
Mount Elizabeth Hospital and Medical Centre, Singapore 228510.
出版信息
Int J Hepatol. 2011;2011:918017. doi: 10.4061/2011/918017. Epub 2011 Jun 23.
Abstract
Chronic hepatitis B infection progresses from an asymptomatic persistently infected state to chronic hepatitis, cirrhosis, decompensated liver disease, and/or hepatocellular carcinoma. About 3% of patients with chronic hepatitis develop cirrhosis yearly, and about 5% of individuals with hepatitis B cirrhosis become decompensated annually. The outcome for patients with decompensated cirrhosis is bleak. Lamivudine, the first oral antiviral agent available for hepatitis B treatment is safe and effective and can improve or stabilize liver disease in patients with advanced cirrhosis and viraemia. Viral resistance restricts its prolonged use. Entecavir and tenofovir are newer agents with excellent resistance profile to date. These and some other antiviral agents are being investigated for optimal use in this rather challenging patient group.
摘要
慢性乙型肝炎感染可从无症状持续感染状态发展为慢性肝炎、肝硬化、失代偿性肝病和/或肝细胞癌。每年约3%的慢性肝炎患者会发展为肝硬化，每年约5%的乙型肝炎肝硬化患者会出现失代偿。失代偿性肝硬化患者的预后不佳。拉米夫定是首个可用于治疗乙型肝炎的口服抗病毒药物，安全有效，可改善或稳定晚期肝硬化和病毒血症患者的肝病状况。病毒耐药性限制了其长期使用。恩替卡韦和替诺福韦是目前耐药性良好的新型药物。正在对这些药物及其他一些抗病毒药物进行研究，以确定在这一颇具挑战性的患者群体中的最佳用药方案。
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