阿德福韦酯联合拉米夫定治疗乙肝肝硬化的疗效观察

To Observe the Curative Effect of Adefovir and Lamivudine in Treatment of Hepatitis B Cirrhosis

目的研究阿德福韦酯片联合拉米夫定片治疗乙肝肝硬化的临床效果。方法对2015年3月—2015年10月收治的78例乙肝肝硬化患者随机分为观察组和对照组,每组39例。对照组给予常规保肝、对症处理和每天拉米夫定片100 mg(每日1次)治疗,观察组除给予与对照组相同的方案治疗外,联用每天阿德福韦酯片100 mg(1次/日)治疗,均连续治疗48周。观察两组患者肝脏Child-Pugh评分、肝功能指标(AST、TBIL、ALB和ALT)、血清学指标及和用药安全性。结果治疗后两组肝功能均有改善,但观察组肝脏Child-Pugh评分(6.82±1.43)分、肝功能指标AST(62.37±7.02)U/L、TBIL(37.28±5.44)μmol/L、ALB(31.47±3.87)g/L和ALT(52.17±2.82)U/L、血清学指标HBV DNA转阴率74.36%和HBe Ag转阴率28.21%,改善明显优于对照组(8.74±1.92)分、(89.85±4.76)U/L、(48.05±4.92)μmol/L、(42.36±3.53)g/L和(71.48±3.16)U/L、48.72%和10.26%,(P<0.05);观察组发生一般不良反应率10.26%,基本与对照组7.69%一致(p>0.05),未发现严重不良反应。结论阿德福韦酯片联合拉米夫定片治疗乙肝肝硬化疗效确切,能明显改善肝功能,且安全性较高,值得在临床治疗中推广应用。

Objective The clinical effect of lamivudine combined with adefovir dipivoxil tablets on the treatment of hepatitis B cirrhosis. Methods On 2015.03-2015.10 from 78 cases of liver cirrhosis patients were randomly divided into observation group and control group, 39 cases in each group. The control group was given conventional protecting liver, symptomatic treatment and daily lamivudine 100mg(once daily) as the treatment, the observation group in addition to give the group the same treatment as the control, in conjunction with every day adefovir dipivoxil tablets 100 mg(once daily) as the treatment,all groups were treated for 48 weeks. To observe the liver function index score, two groups of patients with liver Child-Pugh(AST, TBIL, ALB and ALT), and the drug safety and serological indicators. Results Child-Pugh score of liver in liver function after the treatment in two groups were improved, but the observation group(6.82 + 1.43), liver function indices AST(62.37±7.02) U/L, TBIL(37.28±5.44)mol/L, ALB(31.47±3.87)g/L and ALT(52.17±2.82)U/L, serological markers of HBV DNA negative conversion rate of HBe Ag seroconversion rate and improve significantly better than the control group(8.74 ±1.92),(89.85±4.76)U/L,(48.05±4.92) μmol/L,(42.36±3.53)g/L and(71.48 ±3.16) U/L, 48.72% and 10.26%(P < 0.05). The observation group occurred in general, adverse reaction rate was 10.26%, and the control group was 7.69%(P>0.05), found no serious adverse reactions. Conclusion adefovir dipivoxil combined with lamivudine tablets in the treatment of hepatitis B cirrhosis curative effect, can significantly improve the liver function and high security, it is worth popularization and application in the clinical treatment.