摘要
目的探究拉米夫定联合阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者的恰当时机。方法回顾性分析杭州师范大学附属医院于2014年1月—2015年1月收治的HBeAg阳性失代偿期乙肝肝硬化患者100例,将给予拉米夫定初始治疗耐药后加用阿德福韦酯挽救治疗的50名患者作为对照组,同时选取给予拉米夫定加阿德福韦酯初始联合治疗的患者50例作为观察组,比较分析2组治疗的临床疗效。结果观察组治疗后谷丙转氨酶(ALT)、总胆红素(TBIL)、Child-Pugh评分和HBV-DNA分别为(62.74±9.88)U/L、(43.27±6.52)μmol/L、(8.27±0.91)分和(0.78±0.19)×103拷贝/ml,低于对照组治疗后,2组治疗后均低于治疗前,观察组治疗后ALB为(39.36±4.49)g/L,高于治疗前及对照组治疗后,差异均具有统计学意义(P<0.05)。2组治疗后ChildPugh分级结果经秩和检验比较,差异有统计学意义(P<0.05);观察组治疗后HBV-DNA和HBeAg阴转率结果分别为64.0%(32/50)和54.0%(27/50),均高于对照组,差异有统计学意义(P<0.05)。结论采用初始联合拉米夫定和阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者临床效果显著,HBeAg血清学转阴率高,且ChildPugh分级评分分数降低,改善肝脏储备功能,血清中HBV-DNA载量降低,临床上值得进一步推广应用。
Objective To explore the appropriate opportunity of Lamivudine combined with adefovir dipivoxil in the treatment of patients with decompensated HBV cirrhosis. Methods The clinical data of 100 patients with decompensated HBV cirrhosis from January in 2014 to January 2014 in our hospital were retrospectively analyzed. Fifty patients were given adefovir dipivoxil after lamivudine resistance as initial treatment（ control group）,50 patients received the initial combination treatment with lamivudine and adefovir dipivoxil（ observation group）. The clinical curative effect was compared between the two groups. Results The Observation group after treatment of ALT,TBIL,Child-Pugh score and HBV-DNA respectively,（ 62. 74 ± 9. 88） U / L,（ 43. 27 ± 6. 52） μmol / L,（ 8. 27 ± 0. 91） and（ 0. 78 ± 0. 19） × 10^3 copies / ml,lower than the control group after treatment,the two groups after treatment than before treatment,ALB（ 39. 36 ± 4. 49） g / L,higher than the control group and the observation group after treatment,the difference is statistically significant（ P〈0. 05）. The Child-Pugh classification results of two groups after treatment compared by the rank inspection,the difference was statistically significant（ P〈0. 05）. The turning negative rate of HBV-DNA and HBe Ag of the observation group after treatment were 64. 0%（ 32 /50） and 54. 0%（ 27 /50）,higher than the control group,the difference was statistically significant（ P〈0. 05）. Conclusion The clinical effect is remarkable for using initial combination lamivudine and adefovir dipivoxil in the treatment of patients with decompensated HBV cirrhosis. The conversion rate of positive HBe Ag to negative HBe Ag is high after the treatment. The regimen can also decrease Child-Pugh classification rating scores,improve liver function,and reduce serum HBV-DNA loads. It is worth further clinical application.
出处
《中华全科医学》
2015年第12期1941-1943,1954,共4页
Chinese Journal of General Practice
关键词
拉米夫定
阿德福韦酯
HBEAG阳性
乙肝肝硬化
时机
Lamivudine
Adefovir dipivoxil
HBe Ag-positive patients
Hepatitis B virus-related liver cirrhosis
The right time
