阿德福韦酯联合恩替卡韦治疗失代偿期乙肝肝硬化的临床效果  

Clinical efficacy of adefovir dipivoxil combined with entecavir in the treatment of decompensated hepatitis B cirrhosis

作　　者：肖峰[1] Xiao Feng(Department of Pharmacy,the 989th Central Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Pingdingshan 467000,China)

机构地区：[1]中国人民解放军联勤保障部队第989中心医院药学部,河南平顶山467000

出　　处：《中国实用医刊》2021年第10期101-104,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨阿德福韦酯联合恩替卡韦治疗失代偿期乙肝肝硬化的临床效果。方法:抽取2017年1月至2018年12月中国人民解放军联勤保障部队第989中心医院收治的失代偿期乙肝肝硬化患者80例,按照药物治疗方式分为阿德福韦酯联合恩替卡韦治疗组(联合组,44例)和阿德福韦酯单药治疗组(对照组,36例)。比较两组患者治疗效果,治疗过程中死亡情况及不良反应发生率,血清乙肝病毒脱氧核糖核酸(HBV DNA)、乙型肝炎病毒e抗原(HBeAg)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)含量变化,随访情况。结果:治疗48周后,联合组治疗有效率为93.18%,对照组治疗有效率为72.22%,两组比较差异有统计学意义(P<0.05)。两组48周的治疗过程中均未见死亡病例。治疗期间两组药物不良反应发生率比较差异未见统计学意义(P>0.05)。与治疗前比较,对照组和联合组治疗48周后血清HBV DNA、HBeAg、ALT、TBIL含量降低,差异有统计学意义(P<0.05);治疗48周后,与对照组比较,联合组血清HBV DNA、HBeAg、ALT、TBIL含量降低,差异有统计学意义(P<0.05)。两组随访1年死亡率比较差异有统计学意义(P<0.05)。结论:ADV和ETV联合用药治疗失代偿期乙肝肝硬化临床效果较好,能降低血清HBV DNA、HBeAg、ALT、TBIL含量,抑制病毒复制,改善肝功能,减少并发症,降低病死率,安全性较高。Objective To investigate the clinical efficacy of adefovir dipivoxil combined with entecavir in the treatment of decompensated hepatitis B cirrhosis.Methods A total of 80 patients with decompensated hepatitis B cirrhosis admitted to the 989th Central Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2017 to December 2018 were enrolled.According to drug treatment methods,they were divided into adefovir dipivoxil combined with entecavir treatment group(combination group,n=44)and adefovir dipivoxil group(control group,n=36).The treatment effects,deaths and incidence of adverse reactions during the treatment,changes of serum levels of HBV DNA,HBeAg,alanine aminotransferase(ALT)and total bilirubin(TBIL),follow-up were compared between the two groups.Results After 48 weeks of treatment,the effective rate of treatment in the combined group was 93.18%,and that in the control group was 72.22%,the difference between the two groups was statistically significant(P<0.05).There was no death in the two groups during the 48-week treatment.There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Compared with before treatment,the serum levels of HBV DNA,HBeAg,ALT and TBIL in the control group and the combination group were significantly reduced after 48 weeks of treatment(P<0.05);after 48 weeks of treatment,compared with the control group,the serum HBV DNA,HBeAg,ALT and TBIL levels in the combined group were decreased(P<0.05).There was significant difference in 1-year mortality between the two groups(P<0.05).Conclusions The combination of ADV and ETV has a good clinical effect in the treatment of decompensated hepatitis B cirrhosis.It can significantly reduce the serum levels of HBV DNA,HBeAg,ALT,TBIL,inhibit virus replication,improve liver function,reduce complications,and reduce mortalit,and high security.

关 键 词：乙型肝炎 肝硬化 阿德福韦酯 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]