Nucleoside(Acid) Analogues In Treating Cirrhosis Of Clinical Effects

0bjective:To Compare of adefovir dipivoxil(ADV), lamivudine (LAM) and Entecavir(ETV) resistant hepatitis B virus cirrhosis of the efficacy and safety, and to explore nucleoside analogues (acid) treatment of decompensated liver cirrhosis and clinical virological response time therapeutic relevance. Methods: The patients collected between 2005-2009 in our department admissions for liver cirrhosis were divided into A group (ADV), B group (LAM) and the C group (ETV) was observed, according to liver function, HBV DNA, and PT were observed its effects were statistically analyzed, and statistical incidence of adverse events and deaths were also recorded. And decompensated group of patients according to virological response standards and cirrhosis Child-Pugh classification criteria were retrospectively analyzed. Result: 81 cases of A group, 86 cases of B group and 79 cases of C group sex, age, HBV-DNA and baseline Child-pugh score comparison P> 0.05, three groups were comparable.In the virologic response in the treatment to 3 months A, B, C group the number of HBV-DNA negative conversion cases were 22 cases (34.3%), 32 cases (47.8%), 30 cases (54.5%); 12 months, respectively when the overcast cases of 36 patients (57.7%), 29 cases (50.0%), 36 cases (76.0%); 24 months, group A and B, respectively negative conversion cases in 20 cases (71.47%), 18 cases (60.0%), 7 cases (87.5%).Biochemical response in the area, in 3 months, 6 months, 12 months, 18 months, 24 months each time point, three groups of ALT, TBIL, ALB decreased significantly after treatment, the difference statistically significant, but between the three groups no significant difference; in Child-pugh score, the three groups of decompensated liver cirrhosis Child-pugh treatment was reduced to 6 months were more than 2 points, the difference was statistically significant, the early treatment group B Child-pugh score decreased more A, C significantly, with the time of treatment, A, C Group Child-pugh score improvement than group B, but the difference was not significant difference. A, B, C group therapy to 12 months were 7.40% and 10.71%, 5.00% had disease progression; to 24 months were 7.69%, 13.33%, 12.50% progress of the disease occurred. Nucleoside (acid) can significantly improve the treatment of decompensated cirrhosis survival, in the follow-up to 6 months, A, B, C group survival rates were 97.2%, 93.5%, 100%; up to 12 months, A, B, C groups survival was 90.0%, 87.0%, 96%, three studies the survival rate was significantly higher than proposed by the anti-viral treatment of non-decompensated cirrhosis survival . Application of ADV, LAM, ETV early virological response group with non-responders at 12 months, Child-pughA level were 84.62%, 42.85%; 85.71%, 46.67% and 92.86%, 41.67%, the difference was statistically Significance (P <0.05), by Chi-square test, P value less than 0.05.1 year, B group Virus breakthrough rate was 13.3%, A, C group was 0; 2 years, A group of virus breakthrough rate was 7.1%, B group of virus breakthrough ratewas 16.67%, C group 0. Conclusion: ADV, LAM, ETV treatment of liver cirrhosis in clinical efficacy and safety similar to, but adefovir dipivoxil, entecavir resistance mutations in HIV rates lower than lamivudine is an effective anti-HBV drugs and the ideal . And suggests that nucleotide (acid) analogues in treating decompensated cirrhosis, the long-term efficacy and early virologic response in patients with a positive correlation exists, and to verify the activity of HBV active replication is an important factor in decompensated cirrhosis occurs.