拉米夫定和阿德福韦酯与恩替卡韦治疗乙肝肝硬化的疗效对比

Comparative Studies on the Efficacy of Entecavir and Lamivudine Combined with Adefovir for HBV Cirrhosis

目的:分析拉米夫定和阿德福韦酯与恩替卡韦治疗乙肝肝硬化的临床疗效。方法:选取2015年1月~2015年12月我院收治的69例乙肝肝硬化患者,按照不同治疗方式将患者分成两组,观察组(35例)和对照组(34例),对照组患者采用恩替卡韦单药进行治疗,观察组患者采用拉米夫定和阿德福韦酯治疗。观察两组患者白蛋白(ALB)、丙氨酸氨转换酶(ATL)、总胆红素(TBIL)、凝血酶原活动度(PTA)好转情况,同时对比两组患者在不同治疗时间段(2周、4周、12周、24周)的HBV-DNA转阴情况。结果:治疗2周、4周后,观察组患者HBV-DNA转阴率明显高于对照组患者(P<0.05);治疗12周、24周后观察组患者HBV-DNA转阴率与对照组比较无明显差异(P>0.05);治疗前、后两组患者ALB、ATL、TBIL、PTA比较无差异(P>0.05);同组比较,治疗后各指标值明显好转于治疗前(P<0.05),治疗期间未出现明显不良反应情况。结论:恩替卡韦单药治疗虽然在短期疗效没有拉米夫定联合阿德福韦酯好,但长期效疗无差异。

Objective:To investigate the clinical efficacy of entecavir and lamivudine combined with adefovir for HBV cirrhosis.Methods:In total,69patients with HBV cirrhosis were admitted and treated in our hospital from January2015to December2015.They were randomly divided into test group(35cases)and control group(34cases).Patients in control group were treated with entecavir,while patients in test group were treated with lamivudine combined with adefovir.After treatment,the efficacy of two groups were compared in albumin(ALB),alanine transferase(ATL),total bilirubin(TBIL),prothrombin activity(PTA),and the changes of HBV-DNA after2,4,12,24weeks.Results:(1)After2,4weeks treatment,the changes of HBV-DNA in test group was significantly higher than that in control group(P<0.05).(2)After12,24weeks treatment,the changes of HBV-DNA had no significant differences in two groups(P>0.05).(3)There were no significant differences in ALB,ATL,TBIL,and PTA before and after treatment(P>0.05).(4)After treatment,the same group was significant better than before treatment without obviously adverse reaction(P<0.05).Conclusions:Entecavir is no better than lamivudine combined with adefovir on short-term,however,for patients with HBV cirrhosis,both of them has the same efficacy on long-term.