拉米夫定联合阿德福韦酯治疗活动性乙型肝炎肝硬化  

Theraputic effect of lamivudine combined with adefovir dipivoxil treatment in active hepatitis B-related cirrhosis

作　　者：邹桂舟[1] 叶珺[1] 郜玉锋[1] 余鑫之[1] 

机构地区：[1]合肥市安徽医科大学附属第二医院肝病科,230601

出　　处：《实用肝脏病杂志》2011年第3期195-196,共2页Journal of Practical Hepatology

基　　金：安徽省卫生厅科学基金资助项目(编号:09A063)

摘　　要：目的观察拉米夫定联合阿德福韦酯治疗活动性乙型肝炎肝硬化的临床疗效及安全性和耐药性。方法 48例患者给予拉米夫定联合阿德福韦酯治疗,另48例单用拉米夫定治疗。连续观察96周。结果联合治疗组和对照组96周病死率分别为10.41%(5/48)和22.91%(11/48,P<0.05);治疗组在治疗48周、96周后,生化指标改善优于对照组;治疗组Child-Pugh评分比对照组改善明显(P<0.05);两组患者并发症发生率有显著性差异(P<0.05);治疗组患者HBV DNA转阴率比对照组显著性提高(P<0.01);治疗组96周未见耐药发生,而对照组48周和96周有10例和12例发生耐药。结论拉米夫定联合阿德福韦治疗能改善活动性乙型肝炎肝硬化患者肝功能和提高生存率,降低耐药率。Objective To evaluate the clinical efficacy and safety of lamivudine（LAM）combined with adefovir dipivoxil（ADV）in treatment of patients with active hepatitis B-related cirrhosis.Methods 96 patients with chronic hepatitis B-related cirrhosis were divided into treatment and control groups.48 patients were treated with LAM combined with ADV,while 48 patients with LAM alone.The patients in both groups were followed-up for 96 weeks.Results The mortality rate at week 96 in combination treatment group（10.41%,5/48）was significantly lower than that in LAM treatment group（22.91%,11/48,P〈0.05）;The patients in combination treatment group had 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.There was no drug tolerance in combination treatment group,but in LAM treatment group at week 48 and week 96 there were 10 and 12 patients being drug tolerance.Conclusion LAM combined with ADV can improve the liver function and prolong the survival and decline drug resistance in patients with active hepatitis B-related cirrhosis.

关 键 词：乙型肝炎 肝硬化 拉米夫定 阿德福韦酯 治疗 

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