阿德福韦酯联合拉米夫定治疗乙肝肝硬化的临床疗效观察  

The clinical curative effect of adefovir and lamivudine in treatment of hepatitis B cirrhosis

作　　者：胡倩[1] 鲁海峰[2] 

机构地区：[1]浙江省人民医院国际医疗中心,浙江杭州310014 [2]浙江大学医学院附属第一医院传染病诊治国家重点实验室,浙江杭州310003

出　　处：《中国现代医生》2015年第32期108-111,共4页China Modern Doctor

基　　金：浙江省医药卫生平台骨干人才计划项目(2012RCB020)

摘　　要：目的对阿德福韦酯联合拉米夫定治疗乙肝肝硬化的临床疗效进行观察和分析。方法选取2013年1-8月住院治疗的活动性代偿期乙肝肝硬化患者100例为研究对象,根据用药方法不同随机分为观察组与对照组,每组50例,两组均予以改善肝功能、抗纤维化、降酶、纠正水和电解质及酸碱平衡、给予营养等对症支持治疗;对照组予拉米夫定100 mg,1次/d,观察组同时予阿德福韦酯10 mg,1次/d,两组均连用12个月。观察并比较两组患者的临床疗效及两组患者治疗前后谷丙转氨酶（ALT）、谷草转氨酶（AST）、血清白蛋白（ALB）、总胆红素（TBII）及肝脏Child-Pugh评分的变化情况、两组患者治疗前后Child-Pugh分级评分。结果观察组的总有效率为92.00%,对照组的总有效率为70.00%,两组疗效比较,差异存在统计学意义（92.00%vs 70.00%,P〈0.05）。观察组与对照组治疗后的Child-Pugh分级评分分别较治疗前显著降低,且观察组的Child-Pugh分级评分显著低于对照组（P〈0.05）。观察组与对照组治疗后的ALT、AST、IBIL分别较治疗前显著降低,两组ALB水平治疗后分别较治疗前显著升高,且观察组治疗后的ALT、AST、TBIL及ALB水平较对照组改善更显著（P〈0.05）。结论阿德福韦酯联合拉米夫定治疗乙肝肝硬化可以提高疗效,改善患者的肝功能及临床症状,值得推广和应用。Objective The clinical curative effect of adefovir and lamivudine in treatment of hepatitis B cirrhosis observation and analysis.Methods 100 patients with active hepatitis B related cirrhosis who were hospitalized from January2013 to August were selected.According to different methods of treatment they were randomly divided into the observation group and control group,50 cases in each,two groups were under improvement of liver function,anti fibrosis,reducing enzyme,correct water,electrolyte and acid-base balance,giving nutrition symptomatic and supportive treatment;patients in control group were treated with lamivudine 100 mg /d,and the observation group also received the therapy of adefovir dipivoxil 10mg/d,two groups used in conjunction for 12 months.The clinical curative effect of the two groups,and ALT,AST,TBIL,ALB,Child-Pugh score in two groups before and after treatment were compared.Results The total effective rate of the observation group was 92.00%,and the total effective rate was 70.00%in the control group,the difference was significant（92.00%vs 70.00%,P〈0.05）.After treatment,the Child-Pugh scores of the observation group and the control group were significantly lower than before treatment,and the Child-Pugh score of the observation group was significantly lower than that in the control group,the difference was significant（P〈0.05）.After treatment,ALT,AST,TBIL and ALB levels were significantly lower than those in the control group,while the ALT,AST,TBIL and ALB levels in the observation group were significantly higher than before treatment（P〈0.05）.The difference was significant（P〈0.05）.Conclusion Adefovir dipivoxil combined with lamivudine in the treatment of hepatitis B related cirrhosis can improve the curative effect,improve liver function and clinical symptoms of the patients,and worthy of promotion and application.

关 键 词：乙肝肝硬化 阿德福韦酯 拉米夫定 肝功能 

分 类 号：R657.3[医药卫生—外科学]