摘要
目的探讨抗病毒治疗对血清HBV DNA阳性的门脉高压症患者术后临床转归的影响。方法将89例HBV DNA阳性乙型肝炎肝硬化伴门静脉高压症患者随机分成治疗组48例,采用选择性断流联合恩替卡韦治疗和对照组41例,采用单纯手术治疗。常规检测肝功能、HBV DNA定量、Child-Pugh评分和肝纤维化指标。结果在术后1 m和3 m时,治疗组患者血清HBV DNA水平分别为(5.79±1.78)lgcopies/L和(4.24±1.61)lgcopies/L,显著低于对照组[分别为(7.90±1.83)lgcopies/L和(6.46±1.43)lgcopies/L,P<0.05];治疗组患者血清ALT和总胆红素较对照组降低,白蛋白升高;治疗组1 a生存率为93.75%,3 a生存率为75%,对照组患者1 a生存率为87.92%,3 a生存率为68.30%,治疗组显著高于对照组(P<0.05)。结论抗病毒治疗可以促进HBV DNA阳性的门脉高压症患者术后肝功能恢复,改善患者预后。
Objective To explore the effect of antiviral therapy on the clinical postoperative prognosis of patients with serum HBV DNA-positive hepatitis B related cirrhosis and portal hypertension （PH）. Methods 89 patients with serum HBV DNA positive liver cirrhosis and PH were randomly divided into intervention group （n=49） receiving selected splenectomy and entecavir,and control group （n=41） receiving selected splenectomy alone. The liver function tests,serum HBV DNA levels,Child-Pugh scores,liver fibrosis markers were routinely obtained, and the survival rates were observed. Results At the end of 1 month and 3 month after surgery,the serum HBV DNA levels in intervention group were （5.79±1.78） lgcopies/L and （4.24±1.61） lgcopies/L,respectively,while it didn’t change in the control group （P〈0.01）;The serum alanine aminotransferase and total bilirubin levels in in-tervention group decreased,albumin increased as compared to those in control （P〈0.01）;the survival rates at 1 a and 3 a in invention group were 93.7% and 75.0%,much higher than 87.9% and 68.3%,in the control （P＆lt;0.05）. Conclusions Antiviral therapy after selected splenectomy in PH patients with positive HBV DNA can promote the 1iver function recovery and better clinical prognosis.
出处
《实用肝脏病杂志》
CAS
2015年第5期472-475,共4页
Journal of Practical Hepatology
基金
2010年安徽省卫生厅医学科研课题项目(编号:2010B008)
关键词
肝硬化
门静脉高压症
恩替卡韦
生存率
Liver cirrhosis
Portal hypertension
Entecavir
Survival rates
