拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期的疗效观察

Efficacy of decompensated cirrhosis of lamivudine combined with adefovir dipivoxil

目的：探讨拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期的临床治疗效果。方法选择2012年1月~2014年1月收治的60例乙肝肝硬化失代偿期患者,将60例患者随机分为观察组与对照组各30例，观察组在加用拉米夫定100 mg/d，每日1次，和阿德福韦酯10 mg/d治疗，每日1次；对照组在加用拉米夫定100 mg/d，每日1次，分别在治疗24周和48周时复查肝功能、HBV-DNA定量。结果治疗48周后，观察组和对照组患者ALT、AST均较治疗前明显降低，而ALB治疗后均较治疗前明显升高，且观察组的ALT、AST、ALB治疗后较对照组改善更显著（P〈0.05）。观察组和对照组患者的HBV-DNA均较治疗前显著降低，且观察组较对照组降低更显著（P〈0.05）。结论拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期可有效改善患者的肝功能及预后，安全性好，值得推广和应用。

Objective To investigate the effect of lamivudine combined with adefovir decompensatedin in threatment of cirrhosis clinical therapeutic. Methods From January 2012 to January 2014,60 cases of hepatitis B patients with de-compensated cirrhosis were randomly divided into observation group and control group of 30 patients,the observation group were treated with lamivudine 100 mg/d, once a day, and adefovir dipivoxil 10 mg/d treatment , once a day ; the control group plus lamivudine 100 mg/d, once a day. The liver function after treatment of 24 weeks and 48 weeks , HBV-DNA quantification were compared. Results After treatment 48 weeks, ALT and AST of observation group and the control group was significantly lower than before treatment, and ALB increased significantly before treatment,ALT, AST, ALB after treatment of the observation group compared with the control group improved more significantly （P〈0.05）. HBV-DNA of observation group and the control group of patients was significantly lower than before treatment, and the observation group decreased more significantly than the control group （P〈0.05）. Conclusion Lamivudine com-bined with adefovir dipivoxil in treatment of decompensated cirrhosis can improve liver function and prognosis, safety, worthy of promotion and application.