拉米夫定联合阿德福韦酯治疗乙型肝炎肝硬化失代偿期患者.docVIP

拉米夫定联合阿德福韦酯治疗乙型肝炎肝硬化失代偿期 本文档由【中文word文档库】提供，转载分发敬请保留本信息； 中文word文档库免费提供海量范文、教育、学习、政策、报告和经济类word文档。 中图分类号：R969.4;R978.7 文献标识码： A *副主任医师，医学硕士。研究方向：肝硬化、乙型肝炎病毒变异的基础和临床。电话：05102523。E-mail：qywang839@126.com 【摘要】 目的 探讨乙型肝炎肝硬化失代偿期 2006年6月至2008年6月在门诊和住院乙型肝炎肝硬化失代偿期,A组单用拉米夫定100mg/d；B组采用阿德福韦酯10mg/d；C组采用阿德福韦酯10mg/d、拉米夫定100mg/d联合治疗；3组均治疗52周。 结果 治疗52周时3 组患者间ALT水平、HBeAg阳性患者血清转换率比较，差异均无统计学意义。C组组患者HBV DNA达到检测水平以下的百分率与B患者比较，差异有统计学意义（P＜0.05）。治疗52周3组间Child-Pugh评分比较差异无统计学意义。3组患者的基因型耐药率分别为20%（6/30）、0、0，A组6例耐药患者测序为rtM204V+rtL180M变异3例, rtM204I+rtL180M变异2例, rtM204I变异1例。 结论 乙型肝炎肝硬化失代偿期采用阿德福韦酯与拉米夫定联合治疗更安全有效。 【关键词】 肝炎，乙型，肝硬化； 治疗； 拉米夫定； 阿德福韦酯； Clinical efficacy of lamivudine in combination with adefovir therapy in patients with decompensated cirrhosis due to hepatitis B QIU Yuan-wang, HUANG Li-hua, HU Tai-hong, ZHOU Hong-yan,WU Huang-yuan,LI Yi-guang. Wuxi Infectious Disease Hospital, Wuxi 214000, China Email: qywang839@126.com 【Abstract】 Objective To evaluate the efficacy and safety of lamivudinedefovir dipivoxil in the treatment of decompensated cirrhosis due to chronic hepatitis B.Methods A total of 92 patients were randomly assigned into three groups. In A group, patients received lamivudine for 52 weeks. In group B, patients received adefovir dipivoxil for 52 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 52 weeks. Results There were no significant difference in the level of ALT and the rate of HBeAg seroconversion among three groups after 52-week treatment (P 0.05). At week 52, there was significant difference in the undetectable HBV DNA rate between group C and group B, and there was no significant difference in the Child-Pugh score among three groups, and the rate of drug resistant genotype was 20%（6/30）、0、0. Three patients had rtM204V+rtL180M, two patients had rtM204I+rtL180M and one patient had rtM204I mutation in group A. Conclusion Adefovir dipivoxil in combination with lamivudine are safe and effective therapy fo