| Objective:Observation the clinical efficacy of entecavir in the treatment of hepatitis B virus associated with liver failure.Method:Retrospective analysis of a total of 52patients hepatitis B virus associated with liver failure which live in liver department of Jinlin university from January 2004~February 2011 , and according to the different treatments, they were divided into treatment group A,treatment group B and control group (the treatment group A patients were treated with comprehensive treatment and entecavir ,and the patients in treatment group B were treated with comprehensive treatment and Lamivudine, the patients in control groups were just treated with comprehensive treatment). We observed the clinical symptoms after treatment changes, including nausea, vomiting, fatigue, psychiatric symptoms , bleeding tendency and so on. And recorded patients liver function, blood coagulation before and after treatment 3-7d and 8-14 d. Results:(1)After of active comprehensive treatment ,for example protect liver Input plasma or human serum albumin ,and antiretroviral therapy .the patients of three group clinical symptoms were improved.(2)Treatment group A of patients after treatment 3-7d ,liver function TBIL down, ALB CHE increased, conventional coagulation PT down, PTA increased ,but the changes have no significant.(3)Treatment group A of patients after treatment 8-14d ,liver function TBIL further decline,CHE ALB increased, conventional coagulation PT down, (P<0.05) PTA increased.(4)The liver change of patients in treatment group A and B after treatment 3-7d:the treatment group A of liver function in patients with ALB, CHE higher than the treatment group B ,but the changes have no significant. The conventional coagulation PT of treatment group A's higher than the treatment group B's ,PTA lower than the treatment group B, but the difference was not statistically significant. Treatment group A and control group comparison of patients with liver function:ALB, TBIL lower than the control group, CHE higher than the control group, but the difference was not statistically significant; coagulation contrast:PT higher than the control group, PTA lower than the control group, the difference was not statistically significant.(5)The liver change of patients in treatment group A and B after treatment 8-14d:the treatment group A of liver function in patients with ALB CHE higher than the treatment group B, but the changes have no significant. The conventional coagulation PT of treatment group A's lower than the treatment group B's, PTA higher than the treatment group B, but the difference was not statistically significant. Treatment group A and control group comparison of patients with liver function: ALB lower than the control group, CHE, TBIL higher than the control group, but the difference was not statistically significant; coagulation contrast:PT higher than the control group, PTA lower than the control group, the difference was not statistically significant. After treatment 3-7d, the control group's liver function TBIL down, but After treatment 8-14d, the control group's liver function TBIL increase. The treatment group A's liver function TBIL always down in two weeks. The treatment group B's liver function TBIL not always down.(6)After regular treatment, the prognosis of the three groups was not significant. (P> 0.05) . But the efficient of treatment group A is higher than the treatment group A and control group.Conclusion:(1)The group of Entecavir treatment improve the patients'gastrointestinal symptoms and coagulation PT.(2)Three groups of patients within 2 weeks in the treatment of liver function and blood coagulation was no significant change in the indicators, and thiis is Consistent with the reporting at home and abroad.(3)The three groups of treatment in two weeks the treatment group A's liver function TBIL always down in two weeks. The treatment group B's liver function TBIL not always down. But the control group's liver function TBIL down, but After treatment 8-14d, the control group's liver function TBIL increase.(4)The efficient of treatment group A is 61.1%, treatment group B is50%, control group is 40.9%.(5)After regular treatment, the prognosis of the three groups was not significant. In order to increase deeply observe the clinical efficacy of entecavir, needs to increased sample size and long-term observation. |