拉米夫定联合阿德福韦酯治疗活动性乙型病毒性肝炎肝硬化临床观察

Clinical observation of lamivudine plus adefovir dipivoxil in active hepatitis B cirrhosis

目的比较拉米夫定联合阿德福韦酯治疗乙型病毒性肝炎肝硬化的临床效果。方法 120例乙型病毒性肝炎肝硬化患者,依据治疗方法分为拉米夫定治疗组(拉米夫定组)、阿德福韦酯治疗组(阿德福韦酯组)、拉米夫定联合阿德福韦酯治疗组(联合组)各40例,3组均连续治疗12个月以上。比较3组治疗6、9、12个月后HBeAg、HBV-DNA转阴率及治疗12个月后肝功能Child-pugh分级情况。结果联合组治疗6个月后HBV-DNA转阴率、治疗12个月后HBeAg转阴率及肝功能Child-pugh分级A级比率高于拉米夫定组和阿德福韦酯组(P<0.05)。结论拉米夫定联合阿德福韦酯在提高乙型病毒性肝炎肝硬化患者HBeAg及HBV DNA转阴率上明显优于单用拉米夫定、阿德福韦酯。

Objective To compare the therapeutic effect of laminvudine （LAM） plus adefovir dipivoxil （ADV） on active hepatitis B cirrhosis. Methods A total of 120 patients with active hepatitis B cirrhosis were divided into three groups： LAM group, ADV group and LAM＋ADV group, with 40 patients in each group. All patients were treated for over 12 months. The HBeAg and HBV-DNA negative conversion rates in 6, 9 and 12 months after treatment, and Child-pugh scores in 12 months after treatment were compared among three groups. Results The HBV-DNA negative conversion rate in 6 months after treatment, and HBeAg negative conversion rate and proportion of Child-push A score in 12 months after treatment were significantly higher in LAM＋ ADV group than those in group LAM and group ADV （P〈0.05）. Conclusions LAM plus ADV is superior to LAM or ADV alone for improving negative conversion rates of HBeAg and HBV-DNA in patients with hepatitis B cirrhosis.