阿德福韦酯联合拉米夫定治疗乙肝肝硬化的临床效果观察

Effect of adefovir dipivoxil combined with lamivudine in treatment of hepatitis B cirrhosis

目的观察阿德福韦酯联合拉米夫定治疗乙肝肝硬化的临床效果。方法将我院收治的240例乙肝肝硬化患者随机分为观察组120例和对照组120例。入院后对照组患者在常规治疗的基础上行单纯的拉米夫定治疗,观察组患者在常规治疗的基础上行阿德福韦酯联合拉米夫定治疗。分别检测两组患者治疗前后的肝功能指标水平及肝脏Child-Pugh评分,血清学指标以及不良反应的发生率。结果治疗后,观察组患者肝功能指标TBIL、ALT、AST及Child-Pugh平均水平明显低于对照组(P<0.01)。观察组患者治疗后HBV DNA、HBeAg转阴率及HBeAg/抗-HBeAb血清转换率均高于对照组(P<0.01)。治疗后,观察组患者不良反应总发生率为13.33%,对照组为12.5%,两组比较,差异无统计学意义(P>0.05)。结论阿德福韦酯联合拉米夫定治疗乙肝肝硬化的临床效果明显优于单纯拉米夫定治疗,能有效增加抗病毒效果,改善患者肝功能,且不良反应少,值得临床推广与应用。

Objective To observe effect of adefovir dipivoxil combined with lamivudine in treatment of hepatitis B cirrhosis. Methods 240 cases of hepatitis B patients with cirrhosis were randomly divided into observation group （ 120 cases） and control group （120 cases）. Patients in control group were given pure lamivudine treatment on the basis of conventional treatment. Patients in observation group were given adefovir dipivoxil combined with lamivudine on the basis of conventional treatment. Liver function indexes levels and liver Child-Pugh score, serological indexes, and the incidence of adverse reactions in two groups were detected before and after treatment. Results After treatment, liver function indexes of TBIL, ALT, AST and Child-Pugh were significantly lower in observation group than those in control group （P 〈 0.01 ）. HBV DNA, HbeAg turn rate and HBeAg/anti-HBeAb serum conversion rate were higher in observaton group than those in control group （P 〈0.01 ）. After treatment, the total incidence of adverse reactions was 13.33% in observation group, 12.5% in control group, there was no statistically difference between two groups （P 〉0.05）. Conclusion Effect of adefovir dipivoxil combined with lamivudine in the treatment of hepatitis B cirrhosis is obviously better than pure lamivudine treatment, they can effectively increase the antiviral effect, improve liver function, and less adverse reactions, be worthy of clinical popularization and application.