联合抗病毒治疗乙肝肝硬化患者纤维化五项指标的临床分析  

Analysis of antiviral therapy on the 5 fibrosis indexes of hepatitis B patients with cirrhosis

作　　者：张铁英[1] 康杰[1] 赵晓伟[1] 

机构地区：[1]宁夏银川市第一人民医院消化内科,宁夏银川750001

出　　处：《宁夏医学杂志》2016年第3期234-237,共4页Ningxia Medical Journal

摘　　要：目的探讨联合抗病毒治疗对乙型肝炎肝硬化患者肝纤维化五项指标的影响,为临床抗病毒治疗的疗效提供参考。方法选择确诊的乙肝肝硬化患者60例,分为对照组和观察组,每组各30例。对照组患者在综合对症、支持和保肝治疗基础上给予口服抗病毒药物拉米夫定100 mg/d,1次/d;观察组患者在对照组的治疗基础上给予口服阿德福韦酯10 mg/d,1次/d。治疗期为48周,分别于试验开始前、第6、12、24、36周和48周抽取患者外周血对肝功能及层粘连蛋白、Ⅲ型前胶原、Ⅳ型胶原、透明质酸酶和脯肽酶等反映肝纤维化的五项指标进行动态观察。结果观察组患者治疗有效率为76.7%,明显高于对照组。2组患者在治疗前后AST、ALT、A/G和TBIL水平随着用药时间的延长而均有所降低,且治疗第36周和48周时组间比较差异有统计学意义(P<0.05)。2组患者在治疗前后LA、HA、IV-C、PCⅢ和PLD水平随着用药时间的延长而均有所降低。对照组患者在用药第36周LA、HA、IV-C、PCⅢ和PLD与用药前相比较明显降低(P<0.05)。观察组患者上述各项指标在第12周时与用药前相比较均已出现明显的降低,且差异有统计学意义;且在第24周时,2组间LA、HA、PCⅢ和PLD含量比较差异有统计学意义(P<0.05)。结论拉米夫定联合阿德福韦酯抗病毒治疗可有效降低乙肝肝硬化患者肝纤维化指标的水平,起到缓解肝硬化进程的作用。Objective To observe the influence of antiviral therapy on the 5 fibrosis indexes of patients with decompensate cirrhosis. Methods 60 patients with decompensate cirrhosis were randomly divided into two groups： the control group and the case group.The patients in control group received oral lamivudine treatment with a dose of 100 mg / day,one time a day on the basis of common support for liver protection treatment. The case group patients were given adefovir dipivoxil in a dose of 10 mg / day,one time a day as the same treatments as the control group. All the medicine was given for 48 weeks. The liver function,LA,HA,IV- C,PCIII and PLD concentration were tested before the trial and 6,12,24,36,48 weeks during the observation period. Results The treatment effective rate in the case group was 76. 7% and significantly higher than that in control group. The AST,ALT,A / G and TBIL levels in the two groups all decreased. Compared with the control group,the indexes in 36 and 48 weeks were statistical significance differences. The LA,HA,IV-C,PCIII and PLD levels in the two groups also decreased. Compared with the indexes tested before the trial,the LA,HA,IV- C,PCIII and PLD in the control group at 36 weeks were significant decreased（ P〈0. 05）. But the indexes in the case group showed significantly decrease as early as the 12 weeks. All fibrosis indexes in the two groups were statistically significant differences in the 24 week（ P〈0. 05）. Conclusion Lamivudine combination with adefovir dipivoxil can decrease the fibrosis indexes effectively in hepatitis B patients with cirrhosis and ease the process of liver cirrohosis.

关 键 词：抗病毒治疗 拉米夫定 阿德福韦酯 肝纤维化 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]