中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 6
Jun.  2016

Effect of antiviral therapy on long-term prognosis of patients with decompensated hepatitis B cirrhosis

DOI: 10.3969/j.issn.1001-5256.2016.06.016
  • Published Date: 2016-06-20
  • Objective To investigate the effect of antiviral therapy on the long- term prognosis of patients with decompensated hepatitis B cirrhosis.Methods A total of 132 patients with decompensated hepatitis B cirrhosis who were hospitalized in The People's Hospital of Lezhi County 3 times or more from May 2009 to May 2012 were enrolled in the study.According to the therapies,the patients were divided into control group(51 patients) and observation group(81 patients).All the patients were followed up for 5 years via outpatient service and by telephone.Child- Pugh score and Model for End- Stage Liver Disease(MELD) score were obtained from all patients,and the reduction in HBV DNA,HBV DNA clearance,and liver function parameters were observed.Clinical outcomes were compared at the end of follow- up between the two groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results The observation group had significantly lower incidence rate of liver cancer,rate of liver transplantation,and mortality rate than the control group(χ2= 4.32,4.33,and 4.71,all P < 0.001).After treatment,the observation group showed a significant reduction in HBV DNA level(t = 20.60,P < 0.001) and had a significantly lower HBV DNA level than the control group(t = 16.40,P < 0.05).After treatment,the observation group had a significantly higher cumulative clearance rate of HBV DNA than the control group(88.89% vs 6.67%,P < 0.05).After treatment,the observation group had a significantly higher serum albumin level and significantly lower levels of total bilirubin(TBil) and alanine aminotransferase(ALT) than the control group(t = 6.77,16.60,and 11.67,all P < 0.001),and both groups showed significant reductions in TBil and ALT after treatment(observation group:t = 25.18 and 23.33,both P < 0.001;control group:t = 6.15 and 7.20,both P < 0.001).The observation group showed a significant increase in serum albumin level after treatment(t = 10.08,P < 0.001).After treatment,the observation group had significantly lower Child- Pugh score and MELD score than the control group(t = 2.27 and 2.24,both P < 0.05),both groups showed significant reductions in Child- Pugh score and MELD score(observation group:t = 9.18 and 8.17,P < 0.001 and P = 0.03;control group:t = 2.93 and 3.12,P = 0.01 and0.04).Conclusion Long- term antiviral therapy can improve the long- term prognosis of patients with decompensated hepatitis B cirrhosis and increase the 5- year survival rate.

     

  • [1]HUANG YB,QIAO Y,CHANG LS,et al.Effect of antiviral therapy on prognosis of patients with decompensated cirrhosis[J].Chin JGastroenterol Hepatol,2011,20(4):331-334.(in Chinese)黄玉波,乔雍,常路丝,等.抗病毒治疗对失代偿期乙肝肝硬化患者预后的影响[J].胃肠病学和肝病学杂志,2011,20(4):331-334.
    [2]LI P,DING HG.Early diagnosis and screening of hepatocellular carcinoma in high-risk popular[J].Chin J Pract Intern Med,2015,35(3):193-193.(in Chinese)李鹏,丁惠国.肝癌危险因素及早期诊断与筛查[J].中国实用内科杂志,2015,35(3):193-195.
    [3]LI YJ.Evaluation on efficacy and safety of adefovir dipivoxil combined with lamivudine treatment for hepatitis B virus-related decompensated cirrhosis patients[J].Pract Pharm Clin Remed,2012,15(12):822-824.(in Chinese)李云静.阿德福韦酯联合拉米夫定治疗乙肝肝硬化失代偿期的疗效及安全性评价[J].实用药物与临床,2012,15(12):822-824.
    [4] Chinese Society of Hepatology Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].J Clin Hepatol,2011,27(1):Ⅰ-ⅩⅥ.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南[J].临床肝胆病杂志,2011,27(1):Ⅰ-ⅩⅥ.
    [5]LUO HF,YANG XA,ZHANG K,et al.Efficacy observation of mesenchymal stem cells derived from human umbilical cord for therapy of hepatitis B patients with decompensated cirrhosis[J].Chinese J Exp Clin Virol,2015,29(3):239-241.(in Chinese)骆海飞,杨小安,张卡,等.人脐带间充质干细胞治疗乙肝肝硬化失代偿期疗效观察[J].中华实验和临床病毒学杂志,2015,29(3):239-241.
    [6]ZHANG JX,YAN J,WEI Y,et al.A cross-sectional survery on the cognition of common sense treatments on liver cirrhosis complications[J/CD].Chin J Exp Clin Infect Dis:Electronic Edition,2015,9(3):401-404.(in Chinese)张俊霞,闫杰,魏阳,等.乙型肝炎肝硬化失代偿期患者对肝硬化并发症治疗常识的认知现状调查[J/CD].中华实验和临床感染病杂志:电子版,2015,9(3):401-404.
    [7]ZHANG QJ,ZHANG J,LI Y,et al.Clinical study of entecavir in the treatment of hepatitis B decompensated liver cirrhosis[J].JGuiyang Coll Tradit Chin Med,2011,33(3):60-62.(in Chinese)张勤俭,张建,李燕,等.恩替卡韦治疗乙肝肝硬化失代偿期的临床研究[J].贵阳中医学院学报,2011,33(3):60-62.
    [8]FENG JH.Therapeutic effects of entecavir therapy for patients with hepatitis B virus related decompensated cirrhosis[J].Med Philosophy,2011,32(8):29-30.(in Chinese)冯继红.恩替卡韦治疗失代偿期乙肝肝硬化临床疗效观察[J].医学与哲学,2011,32(8):29-30.
    [9]FU WZ,YANG L.Clinical features and prognoses of decompensated liver cirrhosis of hepatitis B with different viral loads[J].Chin Gen Pract,2013,16(14):1672-1674.(in Chinese)付万智,杨丽.不同病毒载量乙型肝炎肝硬化失代偿期患者的临床特征及转归情况分析[J].中国全科医学,2013,16(14):1672-1674.
    [10]NIE QH.Clinical practice of antiriral treatment for liver cirrhosis patients with chronic hepatitis B[J].Chin J Pract Intern Med,2014,34(6):568-571.(in Chinese)聂青和.核苷酸类似物药物治疗乙型肝炎肝硬化的临床实践[J].中国实用内科杂志,2014,34(6):568-571.
    [11]YANG Y,CHEN JS,OU XJ,et al.Follow up study of HBV-induced decompensated cirrhosis treated with nucleot(s)ide analogues[J].J Capit Med Univ,2010,31(5):573-577.(in Chinese)杨烨,陈景寿,欧晓娟,等.核苷(酸)类似物治疗失代偿期乙肝肝硬化的随访研究[J].首都医科大学学报,2010,31(5):573-577.
    [12]TANG MG.Clinical study of nucleoside(nucleotide)analogues in the treatment of decompensated hepatitis B cirrhosis[J].Mod J Integr Tradit Chin West Med,2015,(3):301-303.(in Chinese)汤茂刚.核苷(酸)类似物治疗乙型肝炎肝硬化失代偿期临床研究[J].现代中西医结合杂志,2015,(3):301-303.
    [13]YANG QE,JIANG YM,SUN T,et al.The clinical curative effect of lamivudine combined with adefovir dipivoxil in senile decompensated liver cirrhosis[J].Chin J Gerontol,2015,35(6):1518-1520.(in Chinese)杨崎恩,蒋亦明,孙彤,等.拉米夫定联合阿德福韦酯治疗老年失代偿期乙肝后肝硬化的临床疗效[J].中国老年学杂志,2015,35(6):1518-1520.
    [14]LIU YS.Clinical observation on adefovir dipivoxil tablets in the treatment of elderly patients with decompensated hepatitis B cirrhosis[J].Chin J Gerontol,2011,31(18):3634-3635.(in Chinese)刘岩山.阿德福韦酯片治疗老年失代偿期乙型肝炎肝硬化的临床观察[J].中国老年学杂志,2011,31(18):3634-3635.
    [15]LI JM.The curative effect and safety of telbivudine in the treatment of decompensated hepatitis B cirrhosis[J].Shandong Med J,2011,51(16):73-74.(in Chinese)李景明.替比夫定治疗失代偿期乙肝肝硬化的疗效及安全性[J].山东医药,2011,51(16):73-74.
  • Relative Articles

    [1]Zhiyao SHI, Xiaofei FAN, Yu GAO, Shaojian REN, Shiyu WU, Xixing WANG. The distribution pattern of traditional Chinese medicine syndromes and influencing factors for primary liver cancer: An analysis of 415 cases[J]. Journal of Clinical Hepatology, 2025, 41(1): 84-91. doi: 10.12449/JCH250113
    [2]Bibi XUAN, Yonghong XU, Zhongcai DU, Yu LIU, Yuling YANG, Cheng BIAN. Influencing factors for low-level viremia in patients with chronic hepatitis B or hepatitis B liver cirrhosis and its association with the progression of liver inflammation and liver fibrosis[J]. Journal of Clinical Hepatology, 2022, 38(10): 2252-2259. doi: 10.3969/j.issn.1001-5256.2022.10.011
    [3]Tao WANG, Fenghui LI, Jing LIANG, Huiling XIANG, Fang LIU, Hongmin LYU, Baoxin QIAN, Jiajun TIAN. Clinical effect of direct-acting antiviral agents in treatment of chronic hepatitis C patients with thrombocytopenia[J]. Journal of Clinical Hepatology, 2022, 38(1): 91-96. doi: 10.3969/j.issn.1001-5256.2022.01.014
    [4]Yuqing YANG, Jia SHANG, Chengzhen LU, Song YANG, Hongyu CHEN, Jiali PAN, Yifan HAN, Hongli XI, Qian KANG, Ning TAN, Xiaoyuan XU. Influencing factors for direct-acting antiviral therapy failure in treatment of hepatitis C[J]. Journal of Clinical Hepatology, 2022, 38(5): 1059-1063. doi: 10.3969/j.issn.1001-5256.2022.05.016
    [5]Jia LIAN, Tao HAN, Huiling XIANG, Yankai YANG, Tinghong LI, Lei LIU, Baiguo XU, Lixia SUN, Fei WANG, Yanchao FU. Influencing factors of rebleeding after gastroscopy in patients with liver cirrhosis and esophagogastric variceal bleeding[J]. Journal of Clinical Hepatology, 2021, 37(9): 2092-2096. doi: 10.3969/j.issn.1001-5256.2021.09.018
    [6]Dongqing ZHANG, Ruidan ZHENG, Minghua LIN, Wenjun WU, Shenglong LIN, Xiangmei WANG, Huaxi MA, Qin LI, Hanhui YE, Haibing GAO. Influencing factors for the 90-day prognosis of patients with HBV-related acute-on-chronic liver failure[J]. Journal of Clinical Hepatology, 2021, 37(10): 2316-2319. doi: 10.3969/j.issn.1001-5256.2021.10.011
    [7]Li YANG, Ke SHI, Fangyuan GAO, Chongping RAN, Jie HOU, Xianbo WANG. Influencing factors for chronic kidney disease in patients with hepatitis B cirrhosis[J]. Journal of Clinical Hepatology, 2021, 37(8): 1817-1821. doi: 10.3969/j.issn.1001-5256.2021.08.015
    [8]Chaoyun XIE, Ping ZHANG, Minkai WANG. Influencing factors for severe acute pancreatitis with sepsis[J]. Journal of Clinical Hepatology, 2021, 37(4): 877-881. doi: 10.3969/j.issn.1001-5256.2021.04.030
    [9]Huibin NING, Huiming JIN, Kuan LI, Zhen PENG, Wei LI, Jia SHANG. Influencing factors for abnormal renal function markers in chronic hepatitis B patients receiving long-term oral administration of entecavir/tenofovir disoproxil fumarate[J]. Journal of Clinical Hepatology, 2021, 37(8): 1798-1801. doi: 10.3969/j.issn.1001-5256.2021.08.011
    [10]Hou YiHui, Liu TengFei, Zhao XiaoQing, Zhang LiaoYun. Effect of different direct-acting antivirals on the clinical outcome of genotype 1b chronic hepatitis C and compensated hepatitis C cirrhosis[J]. Journal of Clinical Hepatology, 2020, 36(1): 84-87. doi: 10.3969/j.issn.1001-5256.2020.01.019
    [11]Liang Jing, Zhang YaPing, Liu Fang, Xiang HuiLing, Lu: HongMin, Han Tao. Efficacy of direct-acting antiviral agents in treatment of chronic hepatitis C and its effect on liver stiffness and aspartate aminotransferase-to-platelet ratio index[J]. Journal of Clinical Hepatology, 2020, 36(6): 1263-1267. doi: 10.3969/j.issn.1001-5256.2020.06.015
    [12]LIU YuWei, JIN JingLan, REN TianYi, GAO XiuZhu, LI Jie, ZHU Qing, NIU JunQi. Effect of direct-acting antiviral on the recurrence hepatitis C virus-related hepatocellular carcinoma after curative treatment: A Meta-analysis[J]. Journal of Clinical Hepatology, 2020, 36(12): 2714-2719. doi: 10.3969/j.issn.1001-5256.2020.12.015
    [13]Lin ShunWei, Zhou ShuDong, Gao YanHui, Li YuePing, Jia WeiDong, Liang YingFang, Yang Yi. Compliance with antiviral therapy in patients with chronic hepatitis B[J]. Journal of Clinical Hepatology, 2020, 36(3): 532-535. doi: 10.3969/j.issn.1001-5256.2020.03.012
    [14]You GuoQiong, Wang Li, Duan Meng, Zhu Peng. Research advances in direct-acting antiviral agents in the treatment of hepatitis C virus-related liver cirrhosis[J]. Journal of Clinical Hepatology, 2019, 35(1): 187-190. doi: 10.3969/j.issn.1001-5256.2019.01.041
    [15]Xu Li, Zheng YueQi, Shi Zhen, Chen YiYun, Shao HuiJiang, Chen JianJie. Influencing factors for the prognosis of primary biliary cholangitis[J]. Journal of Clinical Hepatology, 2019, 35(8): 1870-1873. doi: 10.3969/j.issn.1001-5256.2019.08.050
    [16]Zhao XiTai, Nie QingHe. Adverse effects, drug interactions, and safety of direct-acting antiviral agents in treatment of hepatitis C[J]. Journal of Clinical Hepatology, 2017, 33(6): 1067-1074. doi: 10.3969/j.issn.1001-5256.2017.06.010
    [17]Rao HuiYing, Wei Lai. The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals[J]. Journal of Clinical Hepatology, 2017, 33(5): 820-824. doi: 10.3969/j.issn.1001-5256.2017.05.005
    [18]Bian DanDan, Zheng SuJun. Influencing factors for the therapeutic effect of direct-acting antiviral agents in hepatitis C[J]. Journal of Clinical Hepatology, 2017, 33(11): 2205-2208. doi: 10.3969/j.issn.1001-5256.2017.11.034
    [19]Liu HongLing, Zhang Min, Zang Hong, Zhou Xia, Yao Hong, Gao YinJie, Zhou ShuangNan, Liu ZhenWen. Clinical efficacy of direct-acting antiviral agents in treatment of patients with hepatitis C recurrence after liver transplantation[J]. Journal of Clinical Hepatology, 2015, 31(12): 2039-2041. doi: 10.3969/j.issn.1001-5256.2015.12.012
    [20]Zhou YouQian, Yin FengMing, Feng JingHua. Regularity of relapse after antiviral treatment in patients with chronic hepatitis C[J]. Journal of Clinical Hepatology, 2012, 28(8): 609-611.
  • Cited by

    Periodical cited type(17)

    1. 李斌华,陈小勇,李雷. 加强门静脉高压症的临床管理,促进失代偿性肝硬化再代偿. 肝脏. 2025(02): 262-265 .
    2. 杨晶艳,刘丽萍,陈梅春,周双红. 慢性乙型肝炎患者服药依从性的影响因素分析. 健康研究. 2024(02): 167-171+176 .
    3. 李斌华,谢峰,闫雪华,陈小勇,李雷,王文青. 综合医院MDT模式下肝硬化门静脉高压症患者全病程管理的探讨. 临床医学研究与实践. 2024(36): 182-185 .
    4. 罗发燕,陈铁霞,罗平平,诸伟红. 慢性乙型肝炎患者服药依从性调查. 预防医学. 2023(11): 966-969+974 .
    5. 蔡冬梅,胡婷婷. 网络互动式健康教育对中青年乙型肝炎患者疾病认知及治疗依从性的影响. 中国医药导报. 2022(04): 166-169 .
    6. 吕卉. 慢性病毒性肝炎患者治疗依从性的相关影响因素分析. 当代护士(上旬刊). 2022(01): 58-60 .
    7. 宋如梅,魏芹,李晶,薛群. “3-PR”参与式健康教育对慢性乙肝患者疾病认知及健康行为的影响. 海军医学杂志. 2022(01): 109-112 .
    8. 王玉美,李雪,范琪琪,王爱敏. 青岛慢性乙型肝炎患者抗病毒治疗服药依从性现状及影响因素分析. 社区医学杂志. 2022(04): 228-232 .
    9. 邓娜娜,周美芳. "5个时刻法"用药宣教应用于慢性乙型肝炎抗病毒治疗中的效果. 国际护理学杂志. 2022(06): 1104-1107 .
    10. 沈璐,周翠梅,张静,薛继华,李惠萍. 慢性乙型肝炎患者抗病毒治疗知信行量表的编制及信效度检验. 中国健康教育. 2021(03): 217-221 .
    11. 李振洁. 延伸护理服务在慢性乙型肝炎患者院外护理中的应用. 河南医学研究. 2021(07): 1329-1331 .
    12. 杨玲. 影响慢性乙型肝炎患者服药依从性相关危险因素及其干预措施分析. 内蒙古医学杂志. 2021(07): 836-838 .
    13. 王蕾,王丹,李汝珂,李长安,赵巍峰. “五个时刻法”延续用药指导在慢性乙型肝炎长期抗病毒治疗中的应用价值. 新乡医学院学报. 2021(06): 526-530 .
    14. 钟丽梅,唐霏林,杨柳琴,陆艳珍,黄桂敏,黄艳. 慢性乙型肝炎患者抗病毒治疗期间自我停药状况及影响因素. 河北医药. 2021(17): 2614-2617 .
    15. 田晓英. 医护药一体化模式对慢性乙型肝炎病人用药依从性及负性情绪的影响. 全科护理. 2021(34): 4857-4859 .
    16. 林顺伟,周舒冬,郜艳晖,李粤平,贾卫东,梁颖芳,杨翌. 慢性乙型肝炎患者抗病毒治疗的依从性分析. 临床肝胆病杂志. 2020(03): 532-535 . 本站查看
    17. 王贵菊,鲁荣华. 1022例慢性乙型肝炎病毒感染者现状及影响因素. 中国卫生工程学. 2020(03): 336-338 .

    Other cited types(4)

  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2406) PDF downloads(405) Cited by(21)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return