阿德福韦酯治疗对乙型肝炎肝硬化患者血清AFP水平的影响

Clinical effect of adefovir dipivoxil on serum alpha-fetoprotein levels in patients with HBV DNA positive liver cirrhosis

目的探讨阿德福韦酯治疗对乙型肝炎肝硬化患者血清AFP水平的影响。方法选择血清HBV DNA阳性,伴血清AFP升高的乙型肝炎肝硬化患者62例,随机分为常规保肝治疗对照组及阿德福韦酯治疗组。观察1年内肝功能、HBV DNA定量、血清AFP水平变化及肝癌发生情况。结果与对照组比,阿德福韦酯治疗组患者血清HBV DNA水平明显下降,肝功能明显改善;血清AFP于短时间内下降明显,大多数于治疗12周时恢复正常,而对照组下降不明显(P<0.01)。结论对于血清AFP升高的乙型肝炎肝硬化患者,阿德福韦酯治疗后若AFP不下降,应警惕肝癌的发生。

Objective To investigate the clinical effect of adefovir dipivoxil on serum alpha-fetoprotein levels in patients with serum HBV DNA positive liver cirrhosis. Methods 62 hepatitis B-related liver cirrhosis patients with increased serum alpha-fetoprotein were randomly divided into two groups. Supporting and symptomatic treatment were given in both groups. Meanwhile,thirty-one patients received adefovir dipivoxil 10mg daily. The liver function tests,serum HBV DNA levels and alpha-fetoprotein were detected,and the occurrence of hepatocellular carcinoma was diagnosed and recorded. Results The serum HBV DNA decreased significantly in patients after antiviral treatment. At the same time,the liver function improved and serum AFP decreased in these patients,while these changes were not found in patients without antiviral therapy. HCC was diagnosed in some patients in both groups,whose serum AFP didn＇t decrease,or decreased in a transient manner. Conclusions HCC should be monitored in hepatitis B cirrhosis patients if serum AFP has no obvious decrease after adefovir dipivoxil treatment.