阿德福韦酯联合拉米夫定对失代偿期乙型肝炎肝硬化患者HBV DNA和ALT复常率的影响

Effect of adeforir dipivoxil combined with lamivudine on the HBV DNA and ALT complex rates in patients with decompensated hepatitis B cirrhosis

目的研究阿德福韦酯联合拉米夫定对失代偿期乙型肝炎肝硬化患者的疗效以及对HBV DNA和谷丙转氨酶(ALT)复常率的影响。方法随机选择2014-06—2016-06就诊的96例失代偿期乙型肝炎肝硬化患者作为研究对象,根据治疗方式的不同将患者分为A、B两组,其中A组患者进行拉米夫定和阿德福韦酯初始联合治疗,B组患者则进行拉米夫定和阿德福韦酯的优化治疗,每组48例,比较两组患者的治疗效果。结果两组患者在治疗前ALT、总胆红素(TBIL)、白蛋白(ALB)等指标差异不大,但治疗后,A组患者各项肝功能指标均显著优于B组,且A组患者治疗后ALT复常率为89.58%,血清HBV DNA转阴率为93.75%,显著高于对照组的68.75%,70.83%(P<0.05)。结论阿德福韦酯与拉米夫定初始联合治疗失代偿期乙型肝炎肝硬化患者的效果比阿德福韦酯与拉米夫定优化治疗的效果更好,可显著改善患者的肝功能,促进HBV DNA转阴和ALT的复常,效果好,实用性强。

Objective To study the curative effect of adefovir and lamivudine on patients with decompensated cirrhosis and hepatitis as well as the influence on the recovery rate of HBV DNA and ALT.Me thods 96 patients with decompensated hepatitis B cirrhosis admitted to our hospital from June 2014 to June 2016 were randomly selected as the subjects.According to the treatment methods,patients were divided into group A and B.Group A were treated with lamivudine and adefovir dipivoxil initial combination therapy while group B were treated with lamivudine and adefovir dipivoxil optimization treatment.With 48 cases in each group,curative effects of the two groups were compared.Re s ults Before treatment,the ALT,TBIL,albumin and other indicators have little difference.After treatment,the liver function indexes of group A were significantly better than those of group B.The ALT recovery rate was89.58% in group A and serum HBV DNA negative rate was 93.75%,which was significantly higher than those of the control group 68.75% and 70.83%（P〈0.05）.Conclus ion The effect of adefovir and lamivudine initial combination therapy in patients with decompensated hepatitis B cirrhosis was better than that of adefovir and lamivudine optimization treatment,significantly improving liver function of patients and promoting HBV DNA negative and ALT recovery rate.It was effective and practical.