摘要
目的:探讨阿德福韦酯联合拉米夫定对乙肝肝硬化患者肝功能的影响及抗病毒疗效。方法:选取西藏自治区人民政府驻成都办事处医院收治的乙肝肝硬化患者156例,随机分为对照组及治疗组,各78例;治疗组以阿德福韦酯联合拉米夫定治疗,对照组以恩替卡韦治疗,2组均治疗12个月后行疗效观察。对比2组治疗前后肝功能、血清病毒学指标及甲胎蛋白(AFP)水平变化,记录治疗过程中的不良反应。结果:2组患者治疗后血清GTP、ALT、AST、TBIL水平均较治疗前显著降低(P<0.05),且治疗组ALT、TBIL水平显著低于对照组(P<0.05)。治疗后2组患者HBeAg、HBV-DNA及AFP水平均较治疗前降低(P<0.05),治疗组HBeAg、AFP水平显著低于对照组(P<0.05),2组间HBV-DNA比较无显著差异(P>0.05);治疗组治疗后ALT复常率、HBeAg转阴率明显高于对照组(P<0.05),2组间HBV-DNA转阴率、HBeAg转换率无显著差异(P>0.05);2组治疗期间无明显药物不良反应及肾功能受损发生。结论:阿德福韦酯联合拉米夫定可显著改善乙肝肝硬化患者肝功能及血清病毒学指标,抗病毒疗效明显优于恩替卡韦单用。
Objective：To explore the effect of adefovir dipivoxil in combined with lamivudine on the liver function in patients with hepatitis B cirrhosis and the antiviral efficacy.Methods：A total of 156 patients with hepatitis B cirrhosis who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 78 cases in each group.The patients in the treatment group were given adefovir dipivoxil in combined with lamivudine,while the patients in the control group were given entecavir.After 12-month treatment,the efficacy was evaluated.The liver function,serum virology indicators,and AFP before and after treatment in the two groups were compared.The adverse reactions during the treatment process were recorded.Results：The serum GTP,ALT,AST,and TBIL levels after treatment in the two groups were significantly reduced when compared with before treatment（P〈0.05）;moreover,ALT and TBIL levels in the treatment group were significantly lower than those in the control group（P〈0.05）.HBeAg,HBV-DNA,and AFP levels after treatmentin the two groups were significantly reduced when compared with before treatment（P〈0.05）,HBeAg and AFP levels in the treatment group were significantly lower than those in the control group（P〈0.05）,and the comparison of HBV-DNA between the two groups was not statistically significant（P〉0.05）.ALT normalization rate and HBeAg negative conversion rate after treatment in the treatment group were significantly higher than those in the control group（P〈0.05）.The comparison of HBV-DNA negative conversion rate and HBeAg conversion rate between the two groups was not statistically significant（P〉0.05）.No obvious drug adverse reactions and liver function damage occurred during the treatment process in the two groups.Conclusions：Adefovir dipivoxil in combined with lamivudine can significantly improve the liver function and serum virology indicators in patients with hepatitis B cirrhosis,with antiviral efficacy significant
出处
《海南医学院学报》
CAS
2017年第5期600-602,606,共4页
Journal of Hainan Medical University
基金
西藏自治区医疗成果项目(2015080912)~~
关键词
乙肝肝硬化
阿德福韦酯
拉米夫定
肝功能
抗病毒
Hepatitis B cirrhosis
Adefovir dipivoxil
Lamivudine
Liver function
Antiviral
