替诺福韦酯与阿德福韦酯治疗代偿期乙肝肝硬化患者的效果比较

Comparison of effects of Tenofovir disoprox and Adefovir dipivoxil in treatment of patients with compensated hepatitis B cirrhosis

目的:比较替诺福韦酯与阿德福韦酯治疗代偿期乙肝肝硬化患者的效果。方法:选取92例代偿期乙肝肝硬化患者为研究对象,按照随机数字表法分为观察组与对照组各46例。对照组给予阿德福韦酯片治疗,观察组给予富马酸替诺福韦二吡呋酯片治疗,比较两组HBV-DNA转阴率、肝功能指标[总胆红素(TBIL)、白蛋白(ALB)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、凝血酶原时间(PT)]水平、甲状腺功能指标[游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)]水平和不良反应发生率。结果:观察组HBV-DNA转阴率为76.09%,明显高于对照组的54.35%,差异有统计学意义(P<0.05);治疗后,两组TBIL、AST、ALT水平均低于治疗前,且观察组明显低于对照组,两组PT均短于治疗前,且观察组明显短于对照组,两组ALB水平均高于治疗前,且观察组明显高于对照组,差异有统计学意义(P<0.05);治疗后,两组FT_(4)、FT_(3)水平均高于治疗前,且观察组高于对照组,两组TSH水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:替诺福韦酯治疗代偿期乙肝肝硬化患者可提高HBV-DNA转阴率,以及改善肝功能指标水平和甲状腺功能指标水平,效果优于阿德福韦酯治疗。

Objective:To compare effects of Tenofovir disoprox and Adefovir dipivoxil in treatment of patients with compensated hepatitis B cirrhosis.Methods:92 patients with compensated hepatitis B cirrhosis were selected as the research objects and were divided into observation group and control group according to the random number table method,46 cases in each.The control group was given Adefovir dipivoxil tablets,while the observation group was given Tenofovir disoproxil fumarate tablets.The negative conversion rate of HBV-DNA,the liver function index levels[total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),alanine aminotransferase(ALT),prothrombin time(PT)],the thyroid function index levels[free thyroxine(FT_(4)),free triiodothyronine(FT_(3)),thyroid stimulating hormone(TSH)]and the incidence of adverse reactions were compared between the two groups.Results:The negative conversion rate of HBV-DNA in the observation group was 76.09%,which was significantly higher than the control group of 54.35%,and the difference was statistically significant(P<0.05).After the treatment,the levels of TBIL,AST,ALT in the two groups were lower than those before the treatment,and those of the observation group were significantly lower than those of the control group;the PT were shorter than those before the treatment,and that of the observation group was significantly shorter than that of the control group;the ALB levels in the two groups were higher than those before the treatment,and that of the observation group was significantly higher than that of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of FT_(4) and FT_(3) in the two groups were higher than those before the treatment,and that of the observation group was higher than that of the control group;the TSH levels in the two groups were lower than those before the treatment,and that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Tenofovir disoprox in the treatment of the patients with compensated hepatitis B cirrhosis can increase the negative conversion rate of HBV-DNA,the levels of liver function indexed and the thyroid function indexes.Moreover,it is superior to Adefovir dipivoxil treatment.