拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期57例临床观察  

Clinical observation of lamivudine combined with adefovir dipivoxil in treating 57 patients with decompensated liver cirrhosis caused by hepatitis B

作　　者：王庆治[1] 王素娟[1] 杜鹏程[1] 张丽萍[1] 张帮杰[1] 

机构地区：[1]新乡医学院第三附属医院消化科,河南新乡453000

出　　处：《临床医学》2012年第8期28-29,共2页Clinical Medicine

摘　　要：目的观察拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期的疗效和安全性。方法 57例乙肝肝硬化失代偿期患者均在保肝、对症、支持、防治并发症等综合治疗的基础上加用拉米夫定100 mg/d和阿德福韦酯10 mg/d口服,观察48周。比较患者在治疗前后的临床表现、生化学指标、病毒学改变、Child-Pugh分级情况。结果 50例(87.7%)患者经治疗后病情缓解并稳定,肝功能明显好转或恢复正常,Child-Pugh积分下降,HBV DNA水平明显下降,部分出现HBeAg/抗HBe血清转换。死亡7例中HBeAg阴性6例,占HBeAg阴性患者的6/31(19.4%)。结论拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期可迅速显著地抑制HBV DNA的复制,促进肝功能的恢复,使Child-Pugh积分下降,缓解病情发展,并且药物安全性好。Objective To observe the efficacy and safety of lamivudine combined with adefovir dipivoxil in treating 57 pa- tients with decompensated liver cirrhosis caused by hepatitis B. Methods Fifty-seven cases of decompensate liver cirrhosis caused by hepatitis B were treated with lamivudine 100 mg/d and adefovir dipivoxil 10 mg/d on the basis of comprehensive treat- ments, such as liver function protecting, symptomatic and supportive treatments and complications preventing, the course was 48 weeks. The clinical symptoms, biochemical indicator, serum HBV DNA level, Child-Pugh degree scores before and after the ther- apy were compared. Results After the treatment, 50（87.7% ） patient~ clinical symptoms and liver function improved, Child- Pugh degree scores decreased, serum HBV DNA levels decreased,and the seroconversion of HBeAg to HBeAb occured in part of the 50 patients. Among the 31 HBeAg-negative patients, six patients （ 19.4% ） died. Conclusion Lamivudine combined with adefovir dipivoxil in treating decompensated liver cirrhosis caused by hepatitis B can evidently and promptly inhibit the replication of HBV DNA, improve the liver function, and decrease the Child-Pugh degree scores. Both drugs are safe.

关 键 词：乙型肝炎病毒 肝硬化失代偿 拉米夫定 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]