阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化失代偿期的临床疗效

发布时间：2018-06-10 11:47

本文选题：乙型肝炎 + 肝硬化　；参考：《重庆医学》2015年34期

【摘要】：目的探究阿德福韦酯片治疗乙型肝炎肝硬化失代偿期的临床效果。方法选取重庆市急救中心2013年4~8月期间收治的70例乙型肝炎肝硬化失代偿期患者作为研究对象,将其随机平均分为两组,每组各35例。研究组采用阿德福韦酯片联合拉米夫定治疗,对照组采用拉米夫定治疗,比较两组患者治疗48周后的肝功能、HBV DNA水平、HBeAg转阴率,同时观察病毒变异率以及不良反应。结果 (1)肝功能:两组患者各项指标与治疗前比较,差异有统计学意义(P0.05),但两组间比较差异无统计学意义(P0.05);(2)HBV DNA水平:两组患者治疗后HBV DNA水平均低于治疗前(P0.05),且两组间比较差异有统计学意义(t=8.04,P0.05);(3)HBV DNA转阴率:研究组转阴率为85.71%(30/35),对照组转阴率为42.86%(15/35)(χ2=10.53,P0.05);(4)病毒变异率以及不良反应:研究组治疗良好,无病毒变异及不良反应;对照组出现5例病毒变异,12例患者出现上消化道出血等不同程度的并发症。结论阿德福韦酯片治疗乙型肝炎肝硬化失代偿期的临床效果显著,联合拉米夫定使用可以增强药物抗病毒效果和安全性,值得临床推广应用。
[Abstract]:Objective to investigate the clinical effect of adefovir dipivoxil tablets in the decompensation of hepatitis B cirrhosis. Methods from April to August 2013, 70 patients with decompensated hepatitis B cirrhosis were randomly divided into two groups, 35 cases in each group. The study group was treated with adefovir tablets combined with lamivudine, while the control group was treated with lamivudine. Results 1) liver function: the indexes of the two groups were compared with those before treatment. The difference was statistically significant (P 0.05), but there was no significant difference between the two groups. The level of HBV DNA in the two groups after treatment was lower than that before treatment (P 0.05), and the difference between the two groups was statistically significant. The negative rate was 85.71% 30 / 35%, and the control group was 42.86%, and 15 / 35% (蠂 ~ 2 / 10. 53% P 0.05%) virus mutation rate and adverse reaction: the study group was well treated. There were no virus variation and adverse reactions, and 5 cases of virus mutation and 12 cases of upper gastrointestinal bleeding were found in control group. Conclusion Adefovir dipivoxil tablet is effective in the treatment of decompensated stage of hepatitis B cirrhosis. The combination of lamivudine and adefovir tablets can enhance the antiviral effect and safety of the drug and is worthy of clinical popularization.
【作者单位】：重庆双桥经济技术开发区医院外科;重庆市急救中心肝胆外科;
【分类号】：R512.62;R575.2

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