阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化失代偿

发布时间：2018-05-06 10:21

本文选题：乙型肝炎 + 肝硬化　；参考：《当代医学》2013年09期

【摘要】：目的观察并探讨阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化失代偿期病人的疗效与药物安全性。方法将102例乙型肝炎肝硬化失代偿期患者随机分为A、B两组,A组50例,B组52例,2组均给予常规护肝及抗纤维化对症治疗,A组在此基础上联合使用阿德福韦酯(10mg/d)、拉米夫定(100mg/d)治疗,B组在常规基础上予阿德福韦酯(10mg/d)治疗,观察并对比不同组别患者肝、肾功能、血清HBV-DNA阴转率、HBeAg转阴率、凝血酶原时间、肝脏Child-pugh评分与药物不良反应。结果治疗48周时各项指标改善程度A组优于B组,A组HBV-DNA阴转率达53.5%,B组为33.9%,差异有统计学意义(P0.05)。A组HBeAg血清转换率达31.6%,B组为21.8%,差异有统计学意义(P0.05)。A组的CTP评分较B组下降明显(P0.05)。A、B两组治疗过程中死亡例数分别为1、2例。其余病例未见严重不良反应。结论阿德福韦酯与拉米夫定均是抗乙肝病毒的理想药物,二者联合治疗乙肝肝硬化失代偿期患者可增加抗病毒效果,能明显改善患者预后。
[Abstract]:Objective to observe the efficacy and safety of adefovir dipivoxil combined with lamivudine in the treatment of patients with decompensated hepatitis B cirrhosis. Methods 102 patients with decompensated hepatitis B cirrhosis were randomly divided into group A (n = 50), group A (n = 50) and group B (n = 52) treated with routine liver protection and anti-fibrosis therapy. Group B was treated with adefovir 10 mg / d on a routine basis. The liver and kidney function, serum HBV-DNA negative conversion rate, prothrombin time, liver Child-pugh score and adverse drug reactions were observed and compared in different groups of patients. Results at 48 weeks after treatment, the degree of improvement of various indexes in group A was better than that in group B (53.5%), and the seroconversion rate of HBeAg in group A was significantly higher than that in group B (33.9%). The CTP score of group A was significantly higher than that of group B (P 0.05). The number of patients who died in the treatment process of the two groups was 1: 2, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05. There were no serious adverse reactions in the other cases. Conclusion both adefovir and lamivudine are ideal antiviral drugs. The combination of adefovir and lamivudine can increase the antiviral effect and improve the prognosis of patients with liver cirrhosis decompensation.
【作者单位】：广东省佛山市第二人民医院感染科;
【分类号】：R512.62

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