拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化的临床疗效及安全性分析  

The clinical effect and safety of the combination treatment of lamivudine and adefovir dipivoxil in decompensated hepatitis B cirrhosis

作　　者：董乐凤 步宝坤 尹燕峰 

机构地区：[1]山东省无棣县人民医院消化内科,251900 [2]山东省无棣县计生妇保服务中心

出　　处：《中国医师进修杂志》2011年第19期27-29,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化的临床疗效及并发症。方法将86例乙型肝炎失代偿期肝硬化患者采用随机数字表法分为对照组和观察组，每组43例，对照组在常规治疗的基础上加服拉米夫定，观察组在对照组的基础上加服阿德福韦酯，治疗12个月后对其临床疗效进行评价。结果两组患者治疗前后丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBil）、白蛋白（ALB）及Child．Pugh评分比较差异均有统计学意义（P〈0．05），观察组治疗后ALT、AST与对照组比较差异有统计学意义（P〈0．05）；观察组HBeAg／HBeAb血清转换率和HBVDNA转阴率高于对照组[86．05％（37／43）比65．12％（28／43），79．07％（34／43）比55．81％（24／43）]，两组比较差异有统计学意义（P〈0．05）；对照组共发生7例次并发症，观察组共发生8例次并发症，两组比较差异无统计学意义（P〉0．05）。结论拉米夫定联合阿德福韦酯治疗乙型肝炎失代偿期肝硬化安全、有效，且临床疗效优于单纯应用拉米夫定。Objective To study the clinical effect and complication of the combination treatment of lamivudine and adeforvir dipivoxil in decompensated hepatitis B cirrhosis. Methods Eighty-six cases of decompensated hepatitis B cirrhosis were divided into the observation group and the control group with 43 cases each by random digits table. The control group was treated with routine treatment and lamivudine, and the observation group was added with adefovir dipivoxil on the base of the treatment in the control group. The clinical effect after 12 months＇ treatment was evaluated. Results After 12 months＇ treatment, the level of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBil）, albumin （ALB） and Child-Pugh grade had significant improvement than that before the treatment in two groups（P 〈 0.05）, and in the observation group they improved more obvious （P 〈0.05）. The frequence of seroconversion of HBeAg/HBeAb and HBV DNA in the observation group was higher than that in the control group [ 86.05% （37/43） vs. 65.12%（28/43）,79.07% （34/43） vs. 55.81%（2g/43）], and the difference between the two groups was significant （P 〈 0.05）. Seven cases of times complications happened in the control group and 8 cases of times complications happened in the observation group and the difference between the two groups was not significant （P 〉 0.05 ）. Conclusion The effect of lamivudine and adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis is superior to the only lamivudine.

关 键 词：肝炎 乙型 慢性 肝硬化 拉米夫定 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]