失代偿期乙型肝炎肝硬化应用拉米夫定联合合理营养规划的临床疗效与预后分析

The analysis of lamivudine treatment combination with reasonable nutrition plan for decompensated cirrhosis patients due to hepatitis B

目的探讨拉米夫定联合合理营养规划治疗失代偿期乙型肝炎肝硬化疗效及预后情况。方法选取本院收治的96例失代偿期乙型肝炎肝硬化患者,随机分为观察组和对照组,对照组患者给予护肝等常规综合治疗,观察组患者在对照组基础上应用拉米夫定联合合理营养规划治疗,比较治疗后两组患者的肝功能情况和血清病理学指标,同时随访12、24、36个月,比较治疗后两组患者的病死率和肝癌发病率。结果两组患者治疗后肝功能指标、血清病毒学指标均有好转,观察组患者治疗后HBeAg转阴率(54.9%)和HBV-DNA转阴率(58.8%))均高于对照组(P<0.05);观察组治疗后总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)和Child-Pugh评分均低于对照组(P<0.05)。随访12、24、36个月,观察组的病死率和肝癌发生率均明显低于对照组(P<0.05)。结论拉米夫定联合合理营养规划治疗失代偿期乙型肝炎肝硬化,能有效改善患者的肝功能及其营养状况,降低肝癌发生率,延长患者生存期,效果显著。

Objective To explore the clinical efifcacy on lamivudine treatment combination with reasonable nutrition plan for decompensated cirrhosis patients due to hepatitis B. Method 96 patients with decompensated cirrhosis in our hospital were included into this study. They were divided into the control group and the observation group. The observation group was treated with lamivudine and reasonable nutrition plan, the control group was treated with the comprehensive treatment. To sort and analyse the following variables：HBV-DNA level, ALT, ALB, TBIL and the rate of hepatocellular carcinoma, death rate at the 12, 24, 36 months. Result The liver function, serum virological indicators and after treatment were better than pre treatment in two group （P〈0.05）, the TBIL, ALT, Child-Pugh in control group was higher than that of observation group. The differences were signiifcant （P〈0.05）;the HBeAg and HBV-DNA negative in observation group was higher than that of control group. The differences were signiifcant （P〈0.05）;the rate of hepatocellular carcinoma, death rate at the 12, 24, 36 months in observation group was lower than that of control group. The differences were signiifcant （P〈0.05）. Conclusion Lamivudine treatment combination with reasonable nutrition plan for decompensated cirrhosis patients due to hepatitis B can effectively improve the clinical efifcacy and reduce the hepatocellular carcinoma and death rate.