The effect of Telbivudine therapy in patients with decompensated cirrhosis caused by HBV
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摘要: 目的观察替比夫定治疗失代偿期乙型肝炎肝硬化患者48周疗效。方法 64例乙型肝炎肝硬化患者分成两组,34例给予替比夫定600mg/d治疗,30例给予拉米夫定100mg/d,持续治疗48周。观察治疗后病毒学、生化学、凝血酶原时间及Child-Pugh计分等变化情况。结果替比夫定组患者血清HBV DNA对数值在治疗前为(5.35±0.58)log10拷贝/ml,在治疗后12、24、36、48w时血清HBV DNA下降值依次为(1.88±0.84)log10拷贝/ml,(2.11±0.84)log10拷贝/ml,(2.17±0.74)log10拷贝/ml,(2.36±0.57)log10拷贝/ml,相比拉米夫定组下降值有明显的统计学差异(P<0.05)。在治疗24周时ALT、AST明显下降,Alb、TBil、PT及Child-Pugh积分等指标均有所改善(P<0.05)。结论替比夫定治疗于失代偿乙型肝炎肝硬化患者在48周内即能快速有效抑制病毒复制,使HBV DNA水平明显下降,同时可以改善肝功能及Child-Pugh积分等指标。Abstract: Objective To study the therapeutic efficacy of telbivudine in patients with decompensated cirrhosis resulting from chronic hepatitis B.Methods A total of 64 patients were divided into two groups, group one patients (n = 34) were received telbivudine 600mg and group two patients (n = 30) were treated with Lamivudine 100mg, orally per day for 48 weeks.The changes were observed at different times including virological and biochemical markers, PT and Child-Pugh score after antiviral therapy.Results In the telbivudine group, the mean serum HBV DNA level was (5.35 ± 0.58) log10 copies/ml, and the mean serum HBV DNA levels were (1.88 ± 0.84) , (2.11 ± 0.84) , (2.17 ± 0.74) and (2.36 ± 0.57) log10 copies/ml at 12, 24, 36 and 48 weeks, respectively.The mean reductions in serum HBV DNA levels were significantly greater in telbivudine group than lamivudine group (P < 0.05) .After 24 weeks of therapy ALT, AST, albumin, total bilirubin and Child-Pugh scores were improved in the telbivdine group (P < 0.05) .Conclusion Telbivudine rapidly and effectively inhibits the replication of HBV in cirrhosis resulting from chronic hepatitis B after 48-weeks of treatment and the reduction in the level of HBV DNA also improves the liver function, PT and Child-Pugh score.
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Key words:
- hepatitis B /
- liver cirrhosis /
- Lamivudine
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