Efficacy of entecavir in treatment of hepatitis B cirrhosis and hypersplenism after partial splenic embolization / 中国基层医药

ABSTRACT

Objective To investigate the efficacy of entecavir after partial embolization in patients with hepatitis B cirrhosis complicated with hypersplenism.Methods From February 2016 to October 2016,the clinical data of 92 patients with hepatitis B cirrhosis and hypersplenism in the First People 's Hospital of Taizhou were retrospectively analyzed.Among them,46 cases were treated with lamivudine antiviral therapy after partial embolization as the control group.46 cases were treated with entecavir tablets after partial embolization as the observation group.After 36 weeks of contact therapy,liver fibrosis was compared between the two groupsprocollagen Ⅲ (PC-Ⅲ),serum hyaluronic acid (HA),collagen Ⅳ (Ⅳ-C).The liver function of the two groups were comparedtotal bilirubin (TBil),alanine transaminase (ALT),albumin (ALB),aspartate aminotransferase (AST).The the control of hepatitis B virus were compared between the two groupsHBeAg/anti-HBe negative,negative HBV DNA.Results Liver fibrosisthe levels of PC-Ⅲ,HA and Ⅳ-C in the observation group were (93.6 ± 31.3) U/L,(83.2 ± 25.4) U/L and (85.5 ± 25.4) μ mol/L,respectively,which were significantly lower than those in the control group [(148.6 ± 24.4) U/L,(152.2 ± 34.5) U/L and (146.1 ± 36.6) μmol/L],the differences were statistically significant (t =3.457,3.848,4.065,all P ＜ 0.05).Liver functionthe levels of TBil,AST and ALT in the observation group were (21.4 ± 5.4) μmol/L,(60.1 ± 20.6) U/L,(52.4 ± 15.4) U/L,respectively,which were significantly lower than those in the control group [(51.1 ± 6.7) μmol/L、(116.4 ± 25.5) U/L、(110.9 ± 20.5) U/L],the differences were statistically significant(t =4.106,3.763,2.945,all P ＜ 0.05).The ALB in the observation group was significandy higher than that in the control group [(31.2 ± 1.5) g/L vs.(35.9 ± 2.8) g/L,t =2.966,P ＜0.05].Hepatitis B virus controlthe observation group and control group had 13 cases and 2 cases in HBeAg/antiHBe negative,respectively,the difference was statistically significant (x2 =5.035,P ＜ 0.05);the observation group and control group were 15 cases,2 cases in HBV DNA negative,respectively,the difference was statistically significant (x2 =5.364,P ＜ 0.05).Conclusion The treatment of entecavir by partial embolization of patients with hepatitis B cirrhosis complicated with hypersplenism can well control the liver function and hepatitis B virus replication and reverse the control of liver fibrosis.Antiviral therapy after embolization has an important role.