Discussion on the meaning of MELD score in the opportunity of the entecavir treatment of HBeAg-negative acute-on-chronic liver failure
10.3760/cma.j.issn.1003-9279.2011.06.020
- VernacularTitle:MELD评分对HBeAg阴性慢加急性肝衰竭患者恩替卡韦治疗时机的意义探讨
- Author:
Ying YAN
1
;
ZHU Li, MAI
;
Jian-yun
;
Ying ZHANG
;
Wei-Min KE
Author Information
1. 中山大学附属第三医院
- Keywords:
Liver failure;
HepatitisB e antigens;
Entecavir;
Evaluation studies;
Mortality
- From:
Chinese Journal of Experimental and Clinical Virology
2011;25(6):466-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the opportunity and effect of internal general treatment added entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B patients in different ranges of MELD score.Methods A total of 101 ACLF of HBeAg-negative chronic hepatitis B patients treated with internal general treatment added entecavir were divided into three groups according to the M ELD score.The mortalities and H BV DNA loads during the initiation of therapy,recovery phase and in deathbed phase were studied.Results 20 of patients with high MELD score ( ≥ 30 ) received ( 14.6 ±14.1 ) days treatment.The difference in MELD score between pre-( 36.03 ± 5.01 ) and post-treatment ( 39.86 ± 5.95 ) was significant ( t =- 2.994,P =0.007 ).There was no significant difference in HBV DNA load between pre-[ ( 4.454 ± 1.714 ) copies log1o/ml ] and post-treatment [ ( 3.979 ± 1.947 ) copies log10/ml ] (t =2.212,P =0.051 ),the mortality was 100％ (20/20).47 of patients with moderate MELD score (22-30) received (51.5 ± 41.6) days treatment.There was no significant difference in MELD score between pre-(25.71 ± 2.47 ) and post-treatment ( 26.18 ± 13.32) ( t =- 0.263,P =0.794).The difference in MELD score between pre-[ (6.084 ± 1.795) copies log10/ml] and post-treatment [ (3.378 ±2.156) copies log10/ml] was significant (t =7.148,P =0.000),the mortality was 53.19％ (25/47).34 of patients with low MELD score (≤22) received (67.2 ±40.9) days treatment.The difference in MELD score was significant between pre-( 18.85 ± 2.72 ) and post-treatment ( 11.68 ± 7.23 ) ( t =5.983,P =0.000).There was significant difference in HBV DNA load between pre-[ (5.945 ± 1.635)copies log10/ml ]and post-treatment [ (2.725 ± 1.194) copies log10/ml ] (t =9.962,P =0.000),the mortality was 2.94％ (1/34).Conclusions The ACLF of HBeAg-negative chronic hepatitis B patients with a low score of MELD score (≤22) mostly survive with internal general treatment added entecavir.The mortality of the patients with a MELD score (22-30) is 53.19％ (25/47).The patients with high MELD score (≥30) which almost lack the opportunitv of treatment.is associated with fatal liver failure and need for emergency liver transplantation.
