拉米夫定联合阿德福韦酯治疗活动性乙型肝炎肝硬化三年疗效观察  

A three year of clinical study on lamivudine combined with adefovir dipivoxil treatment in active hepatitis B cirrhosis

作　　者：李惠珍[1] 周小平[1] 李玉珍[2] 雷小刚[1] 陈蕊丽[1] 

机构地区：[1]解放军第一医院感染病科,兰州市730030 [2]甘肃省白银市第一人民医院药剂科

出　　处：《实用肝脏病杂志》2009年第4期265-267,共3页Journal of Practical Hepatology

摘　　要：目的观察拉米夫定(LAM)联合阿德福韦酯(ADV)治疗活动性乙型肝炎肝硬化的临床疗效及安全性。方法将107例活动性乙型肝炎肝硬化患者随机分为治疗组和对照组,治疗组61例给予基础治疗的同时加用拉米夫定治疗,6个月时联合阿德福韦酯治疗;对照组46例只给予基础治疗。连续观察3年的临床疗效。结果接受抗病毒治疗的3例患者因未遵守治疗方案并在1年内死亡而被剔除。治疗组3年病死率(6.9%,4/58)明显低于对照组(43.5%,20/46,P<0.05);治疗组患者在治疗1年、2年和3年后,肝功能指标和Child-Pugh计分均比对照组改善明显(P<0.05);两组患者并发症发生率的比较有显著性差异(P<0.05);治疗组患者HBVDNA转阴率比对照组显著性提高(P<0.01);患者对LAM及ADV耐受性良好,未见明显的不良反应。结论LAM联合ADV治疗能改善活动性乙型肝炎肝硬化肝功能和提高生存率。Objective To evaluate the clinical efficacy and safety of lamivudine （LAM） combined with adefovir dipivoxil（ADV） in treatment of active hepatitis B cirrhosis patients. Methods 107 patients with chronic hepatitis B-related cirrhosis were randomly divided into treatment and control groups. 61 patients were treated with LAM for 6 months, followed by combination LAM and ADV,while 46 patients were treated with supporting treatment. The patients in both groups were followed-up for three years. Results Three patients receiving antiviral therapy were rulled out. The mortality at year three in antiviral treatment group（6.9%,4/58） was significantly lower than that in supporting treatment group （43.5%, 20/46,P〈0.05）;The patients in antiviral treatment group bad their liver founction tests and Child-Pugh scores improved and complications decreased more significantly;No obvious adverse reactions was found in patients when taking the medicine. Conclusion LAM combined with ADV can improve the liver function and prolong the survival in patients with active hepatitis B cirrhosis.

关 键 词：乙型肝炎 肝硬化 拉米夫定 阿德福韦 治疗 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]