恩替卡韦联合拉米夫定对失代偿期乙型肝炎肝硬化的三年随访疗效观察

Observation on three-year follow-up curative effect of entecavir combined with lamivudine on decompensated hepatitis B cirrhosis

目的 观察恩替卡韦与拉米夫定联合用药对失代偿期乙型肝炎肝硬化的长期疗效.方法 抽取失代偿期乙型肝炎肝硬化患者为研究对象,分为观察组（恩替卡韦与拉米夫定联合用药）和对照组（拉米夫定单独用药）,观察随访前后患者的肝功能指标、体内乙肝病毒（HBV-DNA）水平、肝脏储备功能量化评估分级标准（Child-Pugh评分）及终末期肝病模型（MELD）评分的变化.结果 随访12、24、36个月,观察组丙氨酸氨基转移酶（ALT）水平、HBV-DNA降低程度、Child-Pugh评分和MELD评分与对照组比较差异均有统计学意义（P〈0.05）.结论 恩替卡韦联合拉米夫定的治疗方案疗效显著,患者肝功能明显改善,乙型肝炎病毒得到很好的控制,药物的耐药性与安全性良好.

Objective To observe the long-term curative effect of entecavir combined with lamivudine on decompensated hepatitis B cirrhosis.Methods The patients with decompensated hepatitis B cirrhosis were selected as study subjects,and were divided into the observation group （entecavir and lamivudine combined therapy） and the control group （lamivudine alone）.The changes of liver function indexes,hepatitis B virus gene （HBV-DNA） level,liver reserve function quantization evaluation grading standard （Child-Pugh score） and model for end-stage liver disease （MELD） score before and after follow-up were observed.Results With 12,24 and 36 months of follow-up,the levels of alanine aminotransferase （ALT）,the decline of serum HBV-DNA level,the Child-Pugh score and MELD score in the observation group were significantly different with those in the control group （all P 〈 0.05）.Conclusions The curative effect of entecavir combined with lamivudine is significant.The liver function in patients is significantly improved,and hepatitis B virus is well controlled.The drug resistance and safety are good.