拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床观察

Clinical efficacy of lamivudine and adefovir therapy in patients with decompensated liver cirrhosis resulting from hepatitis B

目的研究拉米夫定(LAM)联合阿德福韦酯(ADV)治疗失代偿期乙型肝炎肝硬化的临床疗效。方法92例失代偿期乙型肝炎肝硬化患者在综合护肝及对症治疗基础上,联合组30例给予拉米夫定100mg/d和阿德福韦酯10mg/d口服;LAM组28例给予拉米夫定100mg/d口服;34例给予阿德福韦酯10mg/d口服。在治疗前和治疗6个月时观察肝功能、HBVM以及血清HBVDNA水平的变化。结果拉米夫定和阿德福韦酯联合组与拉米夫定组和阿德福韦酯组HBVDNA阴转率分别为80%、53.6%和41.2%,联合组明显优于单用组(P<0.05);肝功能Child-Pugh计分分别为7.0±1.1、7.7±1.2和7.8±1.3,联合组明显优于单用组(P<0.05)。结论拉米夫定联合阿德福韦酯抗病毒治疗失代偿期乙型肝炎肝硬化优于单用拉米夫定或阿德福韦酯治疗。

Objective To evaluate the clinical efficacy of lamivudine and adefovir therapy in patients with decompensated liver cirrhosis resulting from hepatitis B. Methods 92 patients with decompensated liver cirrhosis resulting from hepatitis B were included and 30 patients with lamivudine l00mg and adefovir 10mg once daily,28 with lamivudine 100mg once daily and 34 with adefovir 10mg once daily for more than six months. Results The negative rate of HBV DNA in combined,lamivudine and adefovir treatment group were 80%,53.6% and 41.2%,respectively;and the Child-Pugh scores were 7.0±1.1,7.7±1.2 and 7.8±1.3,respectively. Conclusion Combination lamivudine and adefovir in treatment of decompensated liver cirrhosis resulting from hepatitis B has an advantage over lamivudine or adefovir treatment alone.