阿德福韦酯和拉米夫定联合治疗肝炎后肝硬化效果及安全性分析.docVIP

阿德福韦酯和拉米夫定联合治疗肝炎后肝硬化效果及安全性分析 　　[摘要]目的 研究对比阿德福韦酯（ADV）联合拉米夫定（LAM）及恩替卡韦（ETV）单药治疗肝炎后肝硬化患者的疗效差异。方法 选取2012年12月～2015年10月在我院治疗的120例乙肝肝硬化患者，随机分为对照组和观察组各60例，两组患者均予常规对症支持治疗，对照组予恩替卡韦治疗，治疗组予阿德福韦酯联合拉米夫定治疗，两组均治疗1年，分别比较两组治疗1个月、2个月、半年、1年时乙型肝炎病毒脱氧核糖核酸（HBV-DNA）转阴率和乙肝E抗原（HBeAg）血清学转换率，比较治疗前及治疗1年后两组患者Child-Pugh评分，清蛋白（ALB）、总胆红素（TBiL）、谷丙转氨酶（ALT）、凝血酶原活动度（PTA）水平及治疗后有无不良反应。结果 比较两组患者治疗1个月～1年后HBV-DNA转阴率、HBeAg血清学转换率，差异无统计学意义（P0.05）；治疗前及治疗1年后各组相比ALT、TBiL水平、Child评分均明显降低，PTA水平明显升高，差异有统计学意义（P0.05）。结论 阿德福韦酯和拉米夫定联合治疗肝炎后肝硬化疗效显著，且安全，值得临床推广应用。 　　[关键词]阿德福韦酯；拉米夫定；恩替卡韦；乙肝肝硬化 　　[中图分类号] R512.62 [文献标识码] A [文章编号] 1674-4721（2017）05（c）-0079-03 　　[Abstract]Objective To study the curative effects of Adefovir ester （ADV） joint Lamivudine （LAM） and Entecavir （ETV） monotherapy in patients with cirrhosis after hepatitis.Methods 120 cases who had hepatitis B cirrhosis treated in our hospital between December 2012 to October 2015 were seleeted，they were randomly divided into control group and observation group，with 60 cases in each group，patients of two groups were given conventional support treatment，control group was given Entecavir treatment，the treatment group was given Adefovir ester joint Lamivudine treatment，after 1 month，2 months， 6 months，1 year treatment， hepatitis B virus DNA（HBV DNA） turn rate and hepatitis B e antigen （HBeAg） serological conversion rate of two groups were compared，before and 1 year after treatment Child-Pugh score，albumin （propagated），total bilirubin （TBiL），alanine aminotransferase （ALT），prothrombin activity（PTA） level，and the presence of adverse reactions after treatment of two groups were compard.Results Two groups of patients in the treatment of 1 month to 1 year was compared with HBV-DNA overcast rate，HBeAg serological conversion rates，there was no statistically significant difference （P0.05）；before treatment and after 1 year of therapy，ALT，TBiL level，Child scores of the two groups were significantly lower，PTA level increased significantly，the difference was statistically significan