Objective To investigate the efficacy of entecavir combined with alprostadil in the treatment of hepatitis B- related cirrhotic ascites. Methods A total of 100 patients with hepatitis B- related cirrhotic ascites who were admitted to Dezhou Hospital of Traditional Chinese Medicine from May 2012 to February 2014 were selected and randomly divided into treatment group and control group,with 50 patients in each group. The patients in both groups received the liver- protecting treatment,diuretic treatment,and intermittent supplementation of albumin( Alb). Additionally,the patients in the treatment group received oral entecavir 0. 5 mg once a day,combined with intravenous infusion of alprostadil 20 μg + 5% glucose injection 100 ml once a day,and those in the observation group only received oral entecavir 0. 5 mg once a day. The patients were hospitalized and treated for 4 weeks. Ascites regression,changes in the levels of alanine aminotransferase( ALT),total bilirubin( TBil),Alb,blood urea nitrogen( BUN),creatinine( Cr),and hepatitis B virus( HBV) DNA,and prothrombin activity( PTA) were observed in both groups. After discharge,the patients in both groups continued to take oral entecavir 0. 5 mg once a day,and the long- term therapeutic effect was observed through follow- up for 3 months. The t- test was applied for comparison of continuous data between groups,and the chi- square test was applied for comparison of categorical data between groups. Results The patients in both groups had varying degrees of reduction in the amount of ascites after treatment,and the treatment group had a significantly higher overall response rate than the control group( χ2= 6. 018,P < 0. 05). The patients in both groups had varying degrees of improvement in each index of liver and renal function( ALT,TBil,Alb,BUN,and Cr) and PTA after treatment; the treatment group had a better treatment outcome than the control group,and there were significant differences in each index after treatment between the treatment group and the control group( t = 7. 567,6. 875,- 4. 782,6. 786,8. 542,and 8. 976,all P < 0. 01). The patients in both groups had varying degrees of reduction in HBV DNA level after treatment( t = 8. 976 and 5. 758,both P < 0. 01),but HBV DNA level showed no significant difference between the two groups after treatment( P > 0. 05). The patients were followed up for 3 months after discharge,and the treatment group had a better treatment outcome than the control group in terms of stabilization of liver and renal function and recurrence of ascites. Conclusion Entecavir combined with alprostadil has a good therapeutic effect in hepatitis B- related cirrhotic ascites,as well as a good long- term effect,and is worthy of clinical application. Entecavir monotherapy does not improve renal function significantly,but can improve liver function significantly.
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