摘要目的 观察核苷类药物对不同病毒载量失代偿性乙肝肝硬化患者的抗病毒疗效及安全性.方法 143例患者分为低病毒载量(HBV-DNA<105拷贝/ml=组46例和高病毒载量(HBV-DNA≥105拷贝/ml)组97例.高、低病毒载量组继续分为治疗组和对照组.治疗组在常规治疗的基础上加用核苷类药物抗病毒治疗48周,对照组给予常规治疗.结果 在治疗观察期间,与对照组相比,低病毒载量治疗组AST明显下降,ALB、CHE明显上升,HBV-DNA转阴率85.7%,两组差异有统计学意义(P<0.05).高病毒载量治疗组与对照组比较,血清AST、ALT、TBIL明显下降,ALB、CHE明显上升,HBV-DNA、HBeAg转阴率分别为96.2%、70%,两组差异有统计学意义(P<0.05).不同病毒载量抗病毒治疗组与对照组比较,肝癌、腹膜炎、消化道出血发生率均有下降,死亡率也低于对照组.结论 核苷类药物能改善不同病毒载量失代偿期乙肝肝硬化肝功能和延缓病情进展.

abstractsObjective To evaluate the efficacy and safety of nueleoside(s)analog in patients with decompensated cirrhosis related to hepatitis B virus with different levels of HBV-DNA loads.Methods One hundred and forty-three patients with decompensated cirrhosis of hepatitis B vires infection were divided into low10e5copies/mL)(97cases).21 cases in low-level group and 52 cases in high-level group were treated with nucleoside(s)analog and liver protective drugs as treatment group,other 25 cases in low-level group and 47 cases in high-level group were treated with liver protective drugs as control group.Supportive treatment and symptomatic treatment were given in four groups.Results In low-level HBV DNA patients,the decrease of AST,the increase of ALB and CHE and the loss of HBV-DNA in treatment group were significant higher than that in control group at week 48(P<0.05).In the high-level HBV-DNA patients,the decrease of AST,ALT and TBil and the increase of ALB and CHE,the loss of HBV-DNA and HBeAg wag higher in treatment group than that in control group(P<0.05).Conclusion nucleoside analog therapy could improve the liver function and slow down the progress of the disease in patients with decompensated HBV cirrhosis with different levels of HBV-DNA load.