拉米夫定联合阿德福韦酯抗病毒治疗在乙肝肝硬化患者中的应用效果

Application effect of antiviral therapy with Lamivudine combined with Adefovir Dipivoxil in patients with hepatitis B cirrhosis

目的分析乙肝肝硬化抗病毒治疗的临床效果。方法选取我院2015年2月~2017年3月诊治的60例乙肝肝硬化患者,按照随机均等分组法分为对照组和观察组,每组各30例。对照组采用常规对症治疗与拉米夫定治疗,观察组采用拉米夫定+阿德福韦酯抗病毒治疗,对比两组不同治疗效果。结果观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);观察组Child-Pugh评分、凝血酶原活动度明显高于对照组,差异有统计学意义(P<0.05),观察组HBV-DNA明显低于对照组,差异有统计学意义(P<0.05);两组干预前Ⅲ型前胶原(PCⅢ)、IVC、LN、HA比较,差异无统计学意义(P>0.05),观察组干预后PCⅢ、IVC、LN、HA肝纤维化指标差异变化水平均明显低于对照组,差异有统计学意义(P<0.05)。两组干预后以上指标差异变化水平均明显低于干预前,差异有统计学意义(P<0.05)。结论拉米夫定联合阿德福韦酯抗病毒用于乙肝肝硬化治疗,临床效果可靠,显著缓解肝纤维化,提升凝血酶原活动度降低HBV-DNA。

Objective To analyze the clinical effect of antiviral therapy in hepatitis B cirrhosis. Methods According to the randomized method, 60 patients with hepatitis B cirrhosis were diagnosed and treated in our hospital from February2015 to March 2017. They were equally divided into control group and observation group, 30 cases in each group. In the control group, routine symptomatic treatment and Lamivudine were used, while in the observation group, Lamivudine Plus combined with Adefovir Dipivoxil as antiviral therapy was adopted. The effect of the two groups were compared. Results The total effectiveness rate of hepatitis B liver cirrhosis in the observation group was significantly higher than that of the control group（P〈0.05）. The Child-Pugh score and prothrombin activity in the observation group were significantly higher than those in the control group（P〈0.05）. HBV-DNA in the observation group was significantly lower than that in the control group（P〈0.05）. There was no significant difference between the two groups before the intervention of PCⅢ, IVC, LN, or HA（P〉0.05）. The changes of differences in liver fibrosis indexes such as PCⅢ, IVC, LN, and HA in the observation group were significantly lower than those in the control group after intervention（P〈0.05）. Besides,the changes of these indexes above-mentioned in the two groups after intervention were significantly lower than those before intervention, which were displayed statistical significance（P 0.05）. Conclusion Lamivudine combined with Adefovir Dipivoxil as anti-virus is effective in the treatment of hepatitis B cirrhosis. The clinical effect is reliable. It can remarkably alleviate the hepatic fibrosis, increase the activity of prothrombin, and reduce HBV-DNA.