Clinical effect of alprostadil combined with entecavir in treatment of HBV-related liver failure complicated by ascites

Objective To investigate the clinical effect of alprostadil combined with entecavir in the treatment of HBV- related liver failure complicated by ascites. Methods A total of 84 patients with HBV- related liver failure complicated by ascites who were hospitalized and treated in No. 97 Hospital of PLA from September 2011 to June 2014 were enrolled and randomly divided into treatment group( 42 patients)and control group( 42 patients). The patients in both groups were given conventional treatment for liver protection,jaundice clearance,diuresis,and albumin nutritional support. The patients in the control group were given entecavir in addition,while those in the treatment group were given alprostadil combined with entecavir in addition. The liver function parameters [total bilirubin( TBil),alanine aminotransferase( ALT),and aspartate aminotransferase( AST) ],prothrombin activity( PTA),HBV DNA load,clinical outcome,24- hour urine volume,and ascites regression before and after treatment were observed and recorded. The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results Both groups had significant changes in the liver function parameters( TBil,ALT,and AST),PTA,and HBV DNA load after treatment( all P < 0. 05). There were significant differences in TBil,ALT,AST,and PTA after treatment between the treatment group and the control group( TBil: 197. 4 ± 47. 6 μmol / L vs287. 5 ± 150. 6 μmol / L,t = 2. 30,P < 0. 05; ALT: 189. 4 ± 63. 8 U / L vs 263. 4 ± 79. 5 U / L,t = 2. 73,P < 0. 05; AST: 138. 7 ± 87. 5 U / L vs 250. 8 ± 90. 4 U / L,t = 3. 43,P < 0. 05; PTA: 63. 5% ± 17. 0% vs 45. 5% ± 15. 1%,t = 2. 60,P < 0. 05). The treatment group had significantly higher marked response rate and overall response rate concerning clinical outcome than the control group( marked response rate:40. 48% vs 28. 57%,χ2= 4. 32,P < 0. 05; overall response rate: 85. 71% vs 66. 67%,χ2= 4. 20,P < 0. 05). The treatment group also had significantly higher marked response rate and overall response rate concerning ascites regression than the control group( marked response rate: 47. 62% vs 23. 81%,χ2= 13. 20,P < 0. 05; overall response rate: 88. 10% vs 52. 38%,χ2= 12. 81,P < 0. 05). Conclusion In patients with severe hepatitis B complicated by ascites,alprostadil combined with entecavir has good clinical effect and safety and can effectively improve the prognosis. Therefore,it holds promise for clinical application.