拉米夫定联合阿德福韦酯治疗乙肝肝硬化的临床疗效观察

The Clinical Observation of Lamivudine Combined with Adefovir Dipivoxil for Treatment of Hepatitis B Cirrhosis

目的:探讨拉米夫定联合阿德福韦酯治疗乙肝肝硬化的临床疗效。方法:本组96例乙肝肝硬化患者,随机分为观察组和对照组,每组48例,两组均给予常规护肝及对症支持治疗。对照组口服拉米夫定治疗,观察组应用拉米夫定联合阿德福韦酯治疗,疗程均为1年。结果:治疗1年后,观察组HBV DNA阴转率为81.3%,对照组HBV DNA阴转率为60.4%,两组比较差异具有统计学意义(P<0.05)。观察组HBeAg/HBeAb血清转换率为52.1%,对照组为27.1%,两组比较差异具有显著性意义(P<0.05)。治疗1年后,治疗后观察组和对照组ALT复常率分别为95.8%和93.7%,两组比较差异无统计学意义(P>0.05)。观察组HBV YMDD变异率为2.1%,明显低于对照组14.6%,差异比较具有统计学意义(P<0.05)。治疗期间两组无一例患者死亡,均未发生严重不良反应。结论:拉米夫定联合阿德福韦酯治疗乙肝肝硬化临床疗效显著,优于单用拉米夫定,值得临床推广应用。

Objective：To explore the clinical efficacy of lamivudine combined with adefovir dipivoxil for treatment of hepatitis B cirrhosis.Methods：96 cases of liver cirrhosis patients were randomly divided into observation group（n = 48） and control group（n = 48）,Conventional liver protection and support therapy were given.The control group was treated with lamivudine,observation group received lamivudine and adefovir dipivoxil therapy for 1 year.Results：After 1 year of treatment,HBV DNA negative conversion rate in observation group was 81.3%,that in control group was 60.4%,the difference was statistically significant（P〈0.05）.HBeAg / HBeAb seroconversion rate in observation group was 52.1%,27.1% in the control group,the difference was significant（P〈0.05）.After 1 year of treatment,ALT normalization rates in the observation group and control group were 95.8% and 93.7%,the difference was not statistically significant（P〈0.05）.HBV YMDD mutation rate observation group was 2.1%,which was significant lower than 14.6% in control group,difference was statistically significant（P〈0.05）.No patients died during treatment,and no serious adverse reactions occurred.Conclusion：The clinical efficacy of lamivudine combined with adefovir dipivoxil treatment of hepatitis B liver cirrhosis was significant better than lamivudine,is worthy of clinical application.