阿德福韦酯联合恩替卡韦治疗慢性乙型肝炎肝硬化患者的效果

Effects of Adefovir dipivoxil combined with Entecavir on patients with chronic hepatitis B cirrhosis

目的:观察阿德福韦酯联合恩替卡韦治疗慢性乙型肝炎肝硬化患者的效果。方法:选取2019年10月至2021年12月该院收治的86例慢性乙型肝炎肝硬化患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各43例。对照组给予恩替卡韦分散片治疗,观察组在对照组基础上联合阿德福韦酯胶囊治疗,比较两组乙型肝炎病毒(HBV)-脱氧核糖核酸(DNA)载量、HBV-DNA转阴率、血清肝功能指标[白蛋白(ALB)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)]水平、血清肝纤维化指标(透明质酸、层粘连蛋白、Ⅲ型前胶原及Ⅳ型胶原)水平和不良反应发生率。结果:治疗后,观察组HBV-DNA载量和血清TBIL、ALT、透明质酸、层粘连蛋白、Ⅲ型前胶原、Ⅳ型胶原水平低于对照组,血清ALB水平高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组HBV-DNA转阴率为86.05%,明显高于对照组的62.79%,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:阿德福韦酯联合恩替卡韦治疗慢性乙型肝炎肝硬化患者可提高HBV-DNA转阴率,改善肝功能指标水平,以及降低HBV-DNA载量和肝纤维化指标水平,效果优于单纯恩替卡韦治疗。

Objective:To observe effects of Adefovir dipivoxil combined with Entecavir in treatment of chronic hepatitis B cirrhosis.Methods:86 patients with chronic hepatitis B cirrhosis admitted to the hospital from October 2019 to December 2021 were selected for the prospective study,and were divided into observation group and control group according to the random number table method,43 cases in each group.The control group was treated with Entecavir dispersible tablets,while the observation group was treated with Adefovir dipivoxil capsules on the basis of that of the control group.The hepatitis B virus(HBV)-deoxyribonucleic acid(DNA)load,the negative conversion rate of HBV DNA,the levels of serum liver function indicators[albumin(ALB),total bilirubin(TBIL),alanine aminotransferase(ALT)],the levels of serum liver fibrosis indicators(hyaluronic acid,laminin,type III collagen and type IV collagen),and the incidence of adverse reactions were compared between the two groups.Results:After the treatment,the HBV-DNA load and the serum TBIL,ALT,hyaluronic acid,laminin,type III procollagen and type IV collagen levels in the observation group were lower than those in the control group,the serum ALB level was higher than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the negative conversion rate of HBV-DNA in the observation group was 86.05%,which was significantly higher than 62.79%in the control group,and the difference was 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:Adefovir dipivoxil combined with Entecavir in the treatment of the patients with chronic hepatitis B cirrhosis can increase the negative conversion rate of HBV-DNA,improve the levels of liver function indexes,and reduce the levels of HBV-DNA load and the liver fibrosis indicators.Moreover,it is superior to single Entecavir treatment.