抗病毒治疗失代偿期乙型肝炎肝硬化的疗效分析.docVIP

抗病毒治疗失代偿期乙型肝炎肝硬化的疗效分析 　　摘要：目的：探析临床应用阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化失代偿期疗效及安全性。方法：本研究随机选取我院2011年2月～2012年7月期间收治的90例乙型肝炎肝硬化失代偿期患者为研究对象，均行临床常规处理，按照随机数字表分为2组，对照组45例给予阿德福韦酯，治疗组45例给予阿德福韦酯联合拉米夫定，观察两组患者肝功能指标、血清HBV-DNA和HBeAg转阴率、Child-Pugh评分以及不良反应等。结果：两组患者经过1年时间的治疗后，两组患者肝功能指标均有所改善，治疗组改善情况更为显著（P0.05）；治疗组血清HBV-DNA、HBeAg转阴率明显高于对照组（P0.05），HBeAg/抗-HBeAg血清转换率低于对照组（P0.05）；Child-Pugh评分明显低于对照组（P0.05）；两组患者在治疗过程中均未出现严重不良反应，无1例死亡。结论：阿德福韦酯和拉米夫定单用对肝炎肝硬化失代偿期均具有一定的疗效，两药联合应用具有更强的抗病毒效果，能明显改善患者预后和生存质量，安全性高，值得在临床中广泛应用和推广。 　　关键词： 阿德福韦酯；拉米夫定；失代偿期；乙型肝炎；肝硬化；疗效 　　Abstract：Objective： decompensated efficacy and safety in the clinical application of adefovir and lamivudine in treatment of hepatitis B cirrhosis. Methods： This study randomly selected from our hospital in 2011 February ～2012 year in July 90 cases of hepatitis B patients with decompensated cirrhosis as the object of study， underwent routine clinical treatment， were randomly divided into 2 groups， 45 cases in the control group were given adefovir dipivoxil， 45 cases in treatment group treated with adefovir and lamivudine， observation of two groups of patients with liver function indices， serum HBV-DNA and HBeAg negative rate， Child-Pugh score and adverse reactions. Results： the two groups of patients after treatment after 1 years， two groups of patients with liver function indexes were improved， the treatment group improved more significantly （P 0.05）； the serum HBV-DNA， HBeAg negative rate was significantly higher than the control group （P 0.05）， the HBeAg/ anti -HBeAg seroconversion rate was lower than the control group （P 0.05）； the Child-Pugh score was significantly lower than that of the control group （P 0.05）； the two group patients were no serious adverse reactions， no death in 1 cases. Conclusion： adefovir Dipivoxil and Ramiv orders with have certain curative effect on hepatitis and decompensated liver cirrhosis， with stronger two drug combination antiviral effect， can significantly improve the prognosis and quality of life of patient