摘要
目的慢加急性肝衰竭(Acute on chronic liver failure,ACLF)的乙肝患者使用核苷类似物(Nucleoside analogues,NUCs)治疗的资料,比较单用拉米夫定和拉米夫定+阿德福韦联合治疗短期内的HBV DNA抑制和预后。方法选择2009年11月-2013年7月住院的69例ACLF乙肝患者,分为拉米夫定治疗的单一组和拉米夫定+阿德福韦治疗的联合组。比较两组入院时和治疗4周后的HBV DNA定量和终末期肝病模型(Model for end-stage liver disease,MELD)评分。结果治疗4周后,单一组血清HBV DNA水平为(4.4±2.1)lg copies/mL,联合组则为(4.7±2.3)lg copies/mL,差异无统计学意义(P>0.05);单一组MELD评分为13.2±9.0,联合组则为18.9±9.2,亦无统计学差异(P>0.05)。结论 ACLF乙肝患者加用拉米夫定单一或拉米夫定+阿德福韦联合治疗短期内虽HBV DNA定量下降,但对预后影响无差异。
Objective To analyze retrospectively the data of hepatitis B patients with acute on chronic liver failure（ACLF） using nucleoside analogues（NUCs） for treatment,comparing the short-term HBV DNA inhibition and patient prognosis as the result of lamivudine monotherapy versus combined treatment with lamivudine and adefovir. Methods 69 hepatitis B patients with ACLF admitted to Sichuan Provincial People＇s Hospital from November 2009 to July 2013 were selected,and were assigned,depending on the NUCs used,into the lamivudine monotherapy group or the lamivudine ＋adefovir combined treatment group. The two groups were compared for HBV DNA level and model for end-stage liver disease（MELD） score at admission and at 4 weeks of treatment. Results At 4 weeks of treatment,the serum HBV DNA level was（4. 4 ± 2. 1） lg copies/ml in the monotherapy group and（4. 7 ± 2. 3） lg copies/ml in the combined treatment group,indicating no statistically significant difference（P〉0. 05）; the MELD score was 13. 2 ± 9. 0 in the monotherapy group and 18. 9 ± 9. 2 in the combined treatment group,indicating no statistically significant difference either（P〉0. 05）. Conclusions For hepatitis B patients with ACLF,addition of both lamivudine monotherapy and combined treatment with lamivudine and adefovir resulted in decreased HBV DNA level in the short term; However there was no significant difference between monotherapy and combined treatment in the effects on prognosis.
出处
《航空航天医学杂志》
2018年第1期28-29,共2页
Journal of Aerospace medicine
