目的 观察恩替卡韦和替比夫定治疗child-pugh B级乙型肝炎肝硬化的疗效及安全性。方法 将70例乙型肝炎肝硬化患者随机分为恩替卡韦组和替比夫定组，每组35例，以治疗48周为观察终点，分析两组疗效、病原学指标改变和不良反应。结果 经48周治疗后，恩替卡韦组和替比夫定组分别有45.7%和37.1%的患者由child-pugh B级改善为child-pugh A级，但两组之间child-pugh 评分没有统计学差异（P>0.05）。恩替卡韦组和替比夫定组患者血清HBV-DNA阴转率分别为91.4%和85.7%，HBeAg转换率分别是22.2%和28.6%，两组HBV-DNA阴转率和HBeAg转换率无统计学差异（P>0.05）。结论 恩替卡韦和替比夫定治疗乙型肝炎肝硬化安全有效。恩替卡韦组较替比夫定组不良反应少。

Objective To observe the therapeutic effects and safety of Entecavir and Telbivudine on child-pugh B grade patients with hepatitis B-induced cirrhosis. Methods 70 child-pugh B grade patients with hepatitis B-induced cirrhosis were randomly divided into Entecavir group and Telbivudine group. There were 35 cases in each group. The patients were treated for 48 weeks, then analyze the therapeutic effects and datas of etiology and adverse reaction of the patients with laboratory Diagnosis and molecular biology analysis. Results After 48 weeks treatment , the child-pugh scores and HBV-DNA levels were lower significantly than pretherapy in Entecavir group and Telbivudine group (P0.05). The rates of serum HBV-DNA undetectable were 91.4% and 85.7% in the two groups respectively. At 48 weeks, the rates of HBeAg seroconversion were 22.2% and 28.6%. But there were not obviously differencies between Entecavir group and Telbivudine group with square test (P>0.05). Conclusions Entecavir and Telbivudine have no significant dfferences on patients with child-pugh scores，the rates of serum HBV-DNA undetectable and the rates of HBeAg seroconversion. But in Telbivudine group there were 3 patients with CK elevated, in Entecavir group there was no obvious daverse reaction. The treatment on child-pugh B grade patients with hepatitis B-induced cirrhosis was safe and effective with Entecavir and Telbivudine.