阿德福韦酯联合拉米夫定治疗失代偿期肝硬化的临床观察

Clinical evaluation of adefovir dipivoxil combined with lamivudine in treatment of decompensated liver cirrhosis due to chronic hepatitis B

目的探讨阿德福韦酯(ADV)联合拉米夫定(LAM)治疗失代偿期乙型肝炎肝硬化的临床疗效。方法 61例失代偿期肝硬化患者在一般治疗基础上,随机分为治疗组及对照组,治疗组31例,给予ADV10 mg/d联合LAM 100 mg/d口服;对照组30例,给予ADV 10 mg/d口服,治疗12个月。治疗前后观察血清总胆红素、血清乙型肝炎病毒(HBV)DNA水平肝功能Child-Pugh评分以及变化。结果治疗组与对照组HBV DNA阴转率分别为87.09%、60.0%,治疗组明显优于对照组;肝功能Child-Pugh评分分别为(6.8±1.4)分、(7.5±1.6)分,治疗组明显优于对照组(P<0.05)。结论 ADV联合LAM治疗失代偿期乙型肝炎肝硬化疗效优于单独使用ADV治疗,且不易产生耐药性,患者能长期稳定病情。

To study the clinical efficacy of adefovir dipivoxil and lamivudine therapy in treatment of patients with decompensated liver cirrhosis caused by hepatitis B. Methods Altogether 61 patients with decompensated liver cirrhosis were included in this study, 31 of them were treated with adefovir dipivoxil 10 mg and lamivudine 100 mg once daily （trial group）, and 30 of them were treated with adefovir dipivoxil 10 mg once daily for 12 months （control group）. The changes in HBV DNA and liver function test were observed before and after treatment. Results The inversion rates of HBV DNA in trial group and control group were 87.09% and 60% respectively; and their Child - Pugh scores were 6.8±1.4 points and 7.5 ±1.6 points respectively. Conclusion Combination of adefovir dipivoxil and lamivudine in treatment of patients with decompensated liver cirrhosis caused by hepatitis B is superior to adefovir dipivoxil alone. The treatment of adefovir dipivoxil combined with lamivudine for liver cirrhosis caused by hepatitis B shows no drug resistance, and patients can receive a long - term stable condition after the treatment.