The Optimization Treatment Of Reverse Hepatitis B Liver Fibrosis/Cirrhosis And Block The Progress Of Disease

Objective:This study by comparing the antiviral,antiviral jointed anti-fibrosis and antiviral combined with immunoregulation to chronic hepatitis B liver fibrosis/decompensated hepatitis B cirrhosis patients in the efficacy of differences,thereby optimized the antiviral treatment program,and ultimately achieved the purpose of improving clinical curative efficacy.Methods:A total of 106 patients with chronic hepatitis B liver fibrosis/decompensated hepatitis B cirrhosis were enrolled whose treatment in Yanbian University Hospital from October 2013 to December 2014.Combined with the results of liver biopsy and randomization of the principle divided 38 cases into the group of liver biopsy,6 cases ended this study observed whose the results of liver biopsy were S0/1,11 cases in the group of Entecavir(ETV),21 cases in group of ETV+Pegylated interferon(PEG-IFN)a-2a/Thymosin(Thy)a-a;68 cases in the group of non-liver biopsy(clinical diagnosis of cirrhosis),33 cases in the group of ETV,35 cases in the group of ETV+Thya-a.Treatment and follow-up observation was conducted according to the drug regimen and assessment table which study designed,according to the primary endpoint events and index of secondary endpoint to evaluate curative effect.Results:In terms of cumulative incidence of the primary end point events,in all research objects,the group of ETV was lower than the group of ETV+PEG-IFN?-2a/Thy?-a at 26 weeks,and higher than the group of ETV+PEG-IFN?-2a/Thy?-a at 52 and 78 weeks;in the group of non-liver biopsy,the group of ETV at each visit points were lower than the group of ETV+Thy?-a.In terms of the treatment of liver fibrosis,in all research objects,the group of liver biopsy and non-liver biopsy,The Aspartate aminotransferase-to-Platelet Ratio Index(APRI)and Liver Stiffness Measurement(LSM)were showed a trend of overall decreased in the group of ETV and ETV+PEG-IFNa-2a/Thya-a.In terms of Child-Pugh and Modelfor end-stage liver disease(MELD)score,in all research objects,the Child-Pugh score at 0 week was higher than 78 weeks,the MELD score at 0 week was higher than 52 and 78 weeks in the group of ETV(P<0.05);in the group of liver biopsy,the MELD score at 0 week was higher than 52 weeks and 26 weeks was higher than 52 and 78 weeks in the group of ETV(P<0.05);in all research objects and the group of liver biopsy,the MELD score at 0 week and 26 weeks were higher than 52 and 78 weeks in the group of ETV+PEG-IFN?-2a/Thy?-a(P<0.05).In terms of virological response,in all research objects,the group of liver biopsy and non-liver biopsy,the quantitative level of Hepatitis B virus deoxyribonucleic acid(HBV DNA)showed a trend of overall decreased in the group of ETV and ETV+PEG-IFN?-2a/Thy?-a;in all research objects and the group of liver biopsy,the cumulative overcast rate of HBV DNA at each visit points in the group of ETV were lower than the group of ETV+PEG-IFN?-2a/Thy?-a;in the group of non-liver biopsy,the cumulative overcast rate of HBV DNA at 52 and 78 weeks in the group of ETV were lower than the group of ETV+Thy?-a;in all research objects and the group of non-liver biopsy,the cumulative incidence rate of HBV DNA virology breakthrough at each visit points in the group of ETV were higher than the group of ETV+PEG-IFN?-2a/Thy?-a.In terms of quality of life improvement,in all research objects and the group of non-liver biopsy,the scores of total and all dimensions were showed a trend of increased in the group of ETV and ETV+PEG-IFN?-2a/Thy?-a;in the group of liver biopsy,the scores of total and all dimensions were showed a trend of increased in the group of ETV,the physiological function scores was showed a trend of gradual decreased,but the scores of total and other dimensions were showed a trend of increased in the group of ETV+PEG-IFN?-2a/Thy?-a.Conclusion:ETV and ETV+PEG-IFN?-2a/Thy?-a could reduced the APRI,LSM,Child-Pugh score,MELD score and quantitative level of HBV DNA in the patients with chronic hepatitis B liver fibrosis/decompensated hepatitis B cirrhosis,sustained antiviral therapy could control these indicators at a lower level,and improved the patient's quality of life in varying degrees.Although ETV+PEG-IFN?-2a/Thy?-a in reduced cumulative incidence of the primary end point events at long-term,increased the cumulative overcast rate of HBV DNA and reduced the cumulative incidence rate of HBV DNA virology breakthrough were superior to ETV.But ETV and ETV+PEG-IFN?-2a/Thy?-a have no significant different efficacy in the above aspects.