Mai Li, Yan Ying, Zhang Shao-Quan, Ke Wei-Min, Cao Hong
Department of Infectious Deseases, The Third Affiliated Hospital of SUN Yat-sen University, Guangzhou 510630, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2013 Aug;27(4):286-8.
To explore relations between the opportunities and effects of internal general treatment added Entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B in different score ranges of acute-on-chronic liver failure severity.
A total of 108 ACLF of HBeAg-negative chronic hepatitis B patients with different ACLF severity score were treated with internal general treatment added Entecavir. The liver failure severity scores, HBV-DNA loads during the initiation of therapy, recovery phase and in deathbed phase, courses of Entecavir administration and mortalities were studied.
For 19 patients with high ACLF score (> or = 12), the difference in ACLF score between pre and post-treatment was not significant. The difference in HBV-DNA load between pre and post-treatment was not significant and the mortality was 18/19. For 30 patients with higher intermediate ACLF score (8-11), the difference in ACLF score between pre and post-treatment was not significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 66.67% (20/30). For 36 patients with lower intermediate ACLF score (5-7), the difference in ACLF score between pre and posttreatment was not significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 30.56% (11/36). For 23 patients with low ACLF score (< or = 4), the difference in ACLF score between pre and post-treatment was significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 8.70% (2/23).
A novel acute-on-chronic liver failure scoring system can syllabify differentiate the relations between the opportunities and efficacies on the Entecavir treatment for HBeAg-negative ACLF.
探讨在不同慢性肝衰竭严重程度评分范围内，恩替卡韦联合内科综合治疗对HBeAg阴性慢性乙型肝炎慢加急性肝衰竭（ACLF）的时机与疗效关系。
108例不同ACLF严重程度评分的HBeAg阴性慢性乙型肝炎ACLF患者接受恩替卡韦联合内科综合治疗。研究肝衰竭严重程度评分、治疗起始时、恢复阶段及临终阶段的HBV-DNA载量、恩替卡韦给药疗程及死亡率。
19例ACLF评分高（≥12分）的患者，治疗前后ACLF评分差异无统计学意义。治疗前后HBV-DNA载量差异无统计学意义，死亡率为18/19。30例ACLF评分较高（8-11分）的患者，治疗前后ACLF评分差异无统计学意义。治疗前后HBV-DNA载量差异有统计学意义，死亡率为66.67%（20/30）。36例ACLF评分较低（5-7分）的患者，治疗前后ACLF评分差异无统计学意义。治疗前后HBV-DNA载量差异有统计学意义，死亡率为30.56%（11/36）。23例ACLF评分低（≤4分）的患者，治疗前后ACLF评分差异有统计学意义。治疗前后HBV-DNA载量差异有统计学意义，死亡率为8.70%（2/23）。
一种新型的慢加急性肝衰竭评分系统能够明确区分恩替卡韦治疗HBeAg阴性ACLF的时机与疗效关系。
