探讨抗病毒治疗乙型肝炎肝硬化失代偿的临床疗效  

Clinical Curative Effect of Antiviral Treatment for Hepatitis B Decompensated Liver Cirrhosis

作　　者：马兰[1] 高有方[1] 王兴民[1] 白连伟[1] 李志刚[1] 张雪雷[1] 

机构地区：[1]安徽省亳州市人民医院感染科,安徽亳州236800

出　　处：《中国医药指南》2012年第29期551-552,共2页Guide of China Medicine

摘　　要：目的对抗病毒治疗乙型肝炎肝硬化失代偿的临床疗效进行探讨研究。方法对2007年2月至2009年7月来自我院的80例乙型肝炎肝硬化失代偿期患者分成观察组和对照组。对照组,给予拉米夫定100mg/d治疗,对于观察组,在给予拉米夫定的基础上加用阿德福韦酯10mg/d,疗程均为96周。结果观察组在治疗48周、96周后,肝功能指标改善明显优于对照组;观察组HBV-DNA阴转率和HBeAg/HBeAb血清转换率都要明显的比对照组的高(P<0.05);观察组96周无耐药发生,对照组48周、96周有7例、11例发生耐药,患者并发症发生率与病死率有显著性差异(P<0.05)。结论拉米夫定联合阿德福韦酯治疗失代偿期肝硬化有很好的疗效,降低耐药率、并发症发生率及病死率,没有严重的不良反应。Objective To investigate the clinical efficacy of therapy ofdecompensate and antiretroviral in chronic hepatitis B cirrhosis.Methods 80cases with chronic hepatitis B cirrhosis in decompensate period were divided into control group and observation group from February 2007 to July 2009 in our hospital.40 cases in the control group were given lamivudine while 40 cases in the observation group were received 10mg/d of adefovir dipivoxilfor 90 weeks on the basis of the control group.The liver function（AST,ALT,TBiL and ALB）,HBV DNA and the rate of HBeAg negative conversion,HBeAg/ HBeAb conversion and virus variation were compared before and after treatment.Results After the treatment,liver function in the observation group improved better than which was in the control group（P0.05）;HBV DNA,the rate of HBeAg negative conversion and HBeAg/HBeAb conversionrate in the observation groups were significant higher than which were in the control group（P0.05）;there was no significant difference of viral mutationrate between the two groups（P0.05）.Conclusion Lamivudine combined with adefovir dipivoxil treating with the decompensated cirrhosis can effectivelydelay or prevent further development of cirrhosis of the liver and improve liver function and can stabilize or improve decompensated cirrhosis;the virusmutation rate is low,and has no serious adverse reaction.

关 键 词：肝硬化 失代偿期 抗病毒 乙型肝炎 

分 类 号：R512.62[医药卫生—内科学]