失代偿期乙型肝炎肝硬化经拉米夫定联合阿德福韦酯治疗的临床观察

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目的探讨拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床效果。方法 65例失代偿期乙型肝炎肝硬化患者作为研究对象,根据入院顺序进行编号并利用随机数表法将患者分为对照组(32例)和观察组(33例)。对照组患者予以拉米夫定治疗,观察组患者在对照组治疗基础上联合阿德福韦酯治疗,观察两组患者的治疗效果,进行临床对照性分析。结果两组患者治疗前各项肝功能指标以及Child-Pugh评分比较差异无统计学意义(P>0.05),治疗后观察组白蛋白(ALB)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、Child-Pugh评分均明显优于对照组(P<0.05);观察组乙型肝炎e抗原(HBe Ag)/乙型肝炎e抗体(HBe Ab)血清转换率为57.6%、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)阴转率为90.9%,明显优于对照组的18.8%、59.4%,差异具有统计学意义(P<0.05)。结论拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床效果突出,值得在临床实践中推广。 Objective To investigate the clinical efficacy of lamivudine combined with adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis. Methods Sixty-five patients with decompensated hepatitis B cirrhosis were enrolled in this study. Patients were divided into control group (n = 32) and observation group (n = 33) according to the order of admission and random number table method. The patients in the control group were treated with lamivudine. The patients in the observation group were treated with adefovir dipivoxil on the basis of the control group. The therapeutic effects of the two groups were observed and the clinical control analysis was performed. Results There was no significant difference in the indexes of liver function and Child-Pugh before treatment between the two groups (P> 0.05). After treatment, the albumin (ALB), alanine aminotransferase (ALT), total bilirubin (TBIL) and Child-Pugh scores were significantly higher than those in the control group (P <0.05). The seroconversion rate of HBeAg / HBeA in the observation group was 57.6% The negative conversion rate of hepatitis B virus DNA (HBV-DNA) was 90.9%, which was significantly better than that of the control group (18.8%, 59.4%). The difference was statistically significant (P <0.05). Conclusion lamivudine combined with adefovir dipivoxil treatment of decompensated hepatitis B cirrhosis of the clinical effect of outstanding, it is worth promoting in clinical practice.
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