恩替卡韦改善了乙型肝炎病毒所致急性肝衰竭的预后

目的：阐明乙型肝炎相关急性肝衰竭的预后因素和恩替卡韦的疗效。方法：本研究回顾性选取了47名因感染乙型肝炎病毒而明确诊断急性肝衰竭的患者,其中5名短期内行肝移植手术被排除,其余42名患者的数据被总结分析。结果：42名患者中12名患者服用了恩替卡韦,在诊断之初,服用恩替卡韦组和未服用恩替卡韦组的一般情况基本相当。使用与未使用恩替卡韦者的生存率分别为67%和23%,此外,年龄〉45岁和没有服用恩替卡韦是不良预后的两个独立相关因素。在年龄〉45岁的患者中使用恩替卡韦和未使用恩替卡韦者的存活率分别为50%和8%。结论：本研究证实了恩替卡韦对乙肝相关急性肝衰竭的治疗作用,我们建议所有乙型肝炎病毒引起的急性肝衰竭患者均应尽早开始恩替卡韦抗病毒治疗。

Entecavir Treatment Improves the Prognosis of Hepatitis B-Associated Acute Liver Failure

Objective： The efficacy of lamivudine for fulminant hepatitis B has been reported, but none of entecavir. The aim of this study was to clarify the prognostic factors and the efficacy of entecavir for hepatitis B-associated acute liver failure. Methods： This study was a retrospective cohort study. We selected 47 consecutive patients with acute liver failure due to hepatitis B virus infection. As 5 of them had received liver transplantation, the data of 42 patients with an average age of 43＋ 14 （range, 20-74） years were analyzed. Results： Entecavir was administered to 12 patients. Therewere no differences in clinical features at the time of the diagnosis of acute liver failure between patients treated with and without entecavir. Survival rates of patients treated with and without entecavir were 67% and 23%, respectively. Age （〉45 years）and non-administration of entecavir were associated with fatal outcomes. The survival rates of patients above 45 years treated with and without entecavir were 50% and 8%, respectively. Conclusion： This study demonstrated the efficacy of entecavir for hepatitis B-associated acute liver failure. We suggested that entecavir is worth administering to patients with hepatitis B-associated acute liver failure.