恩替卡韦联合阿德福韦酯治疗38例乙型肝炎肝硬化的临床疗效探讨

Clinical Efficacy of Entecavir Combined with Adefovir Dipivoxil in the Treatment of 38 Cases of Hepatitis B Crrhosis

目的:探讨乙型肝炎肝硬化患者联合应用恩替卡韦与阿德福韦酯治疗的疗效。方法:将76例代偿期乙型肝炎肝硬化患者选择为本研究的观察对象,随机将其均分为研究组和对照组,各有患者38例。应用恩替卡韦治疗的为对照组,应用恩替卡韦与阿德福韦酯治疗的为研究组。检测两组治疗后血清HBV-DNA阴转率,比较治疗前与治疗后两组肝功能及肝纤维化指标水平的变化。结果:治疗后第8、12、24及48周,两组HBV-DNA阴转率之间比较,差异无统计学意义(P>0.05)。两组ALT、AST、TBIL水平经过治疗后,均低于治疗前,ALB水平均高于治疗前(P>0.05)。研究组ALT、AST、TBIL水平经过治疗后较对照组降低,ALB水平较对照组升高(P<0.05)。两组HA、LN、PCⅢ水平治疗后均低于治疗前(P<0.05)。研究组HA、LN、PCⅢ水平治疗后较对照组降低(P<0.05)。结论:乙型肝炎肝硬化患者在应用恩替卡韦治疗的基础上加用阿德福韦酯治疗,可以改善患者肝功能,延缓肝纤维化进程,取得的疗效也满意。

Objective:To investigate the efficacy of entecavir combined with adefovir dipivoxil in the treatment of patients with hepatitis B cirrhosis.Method:76 patients with compensated hepatitis B cirrhosis were randomly divided into study group and control group,with 38 patients in each group.Those treated with entecavir were the control group and those treated with entecavir and adefovir dipivoxil were the study group.The negative conversion rate of serum HBV-DNA was detected in the two groups after treatment,and the changes of liver function and liver fibrosis indexes in the two groups before and after treatment were compared.Result:There was no significant difference in the negative conversion rate of HBV-DNA between the two groups at 8,12,24 and 48 weeks after treatment(P>0.05).After treatment,the levels of alt,AST and TBIL in the two groups were lower than those before treatment,and the levels of Alb were higher than those before treatment(P>0.05).The levels of alt,AST and TBIL in the study group were lower than those in the control group after treatment,and the level of Alb was higher than that in the control group(P<0.05).The levels of HA,LN and PCⅢin the two groups were lower than those before treatment(P<0.05).The levels of HA,LN and PCⅢin the study group were lower than those in the control group after treatment(P<0.05).Conclusion:Patients with hepatitis B cirrhosis treated with entecavir plus adefovir dipivoxil can improve their liver function and delay the process of liver fibrosis.