拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期疗效观察.docVIP

拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期疗效观察 　　[摘要] 目的 探讨拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期的临床治疗效果。 方法 选择2012年1月～2014年1月收治的60例乙肝肝硬化失代偿期患者，将60例患者随机分为观察组与对照组各30例，观察组在加用拉米夫定 100 mg/d，每日1次，和阿德福韦酯10 mg/d治疗，每日1次；对照组在加用拉米夫定 100 mg/d，每日1次，分别在治疗24周和 48周时复查肝功能、HBV-DNA定量。 结果 治疗48周后，观察组和对照组患者ALT、AST均较治疗前明显降低，而ALB治疗后均较治疗前明显升高，且观察组的ALT、AST、ALB治疗后较对照组改善更显著（P0.05）。观察组和对照组患者的HBV-DNA均较治疗前显著降低，且观察组较对照组降低更显著（P0.05）。 结论 拉米夫定联合阿德福韦酯治疗乙肝肝硬化失代偿期可有效改善患者的肝功能及预后，安全性好，值得推广和应用。 　　[关键词] 乙肝肝硬化；失代偿期；拉米夫定；联合；阿德福韦酯 　　[中图分类号] R575 [文献标识码] B [文章编号] 1673-9701（2014）27-0045-03 　　[Abstract] Objective To investigate the effect of lamivudine combined with adefovir decompensatedin in threatment of cirrhosis clinical therapeutic. Methods From January 2012 to January 2014，60 cases of hepatitis B patients with decompensated cirrhosis were randomly divided into observation group and control group of 30 patients，the observation group were treated with lamivudine 100 mg/d， once a day， and adefovir dipivoxil 10 mg/d treatment ， once a day ； the control group plus lamivudine 100 mg/d， once a day. The liver function after treatment of 24 weeks and 48 weeks ， HBV-DNA quantification were compared. Results After treatment 48 weeks， ALT and AST of observation group and the control group was significantly lower than before treatment， and ALB increased significantly before treatment，ALT， AST， ALB after treatment of the observation group compared with the control group improved more significantly（P0.05）. HBV-DNA of observation group and the control group of patients was significantly lower than before treatment， and the observation group decreased more significantly than the control group （P0.05）. Conclusion Lamivudine combined with adefovir dipivoxil in treatment of decompensated cirrhosis can improve liver function and prognosis， safety， worthy of promotion and application. 　　[Key words] Cirrhosis； Decompensation； Lamivudine； Joint； Adefovir dipivoxil 　　失代偿期乙型肝炎肝硬化治疗困难、并发症多、预后差，选择有效的抗病毒药物进行治疗是改善预后的关键[1]。拉米夫定为双脱氧核苷类似物，具有竞争性抑制乙肝病毒的逆转录过程，从而抑制病毒复制的