摘要
目的比较阿德福韦酯联合拉米夫定与恩替卡韦单药治疗乙肝肝硬化的疗效。方法选择我院收治的乙肝肝硬化患者83例分为两组,观察组42例,采用阿德福韦酯联合拉米夫定治疗,对照组41例,采用恩替卡韦单独用药治疗,两组疗程均为48周。治疗后8、12、24及48周检测血清HBV-DNA阴转率及肝肾功能等指标。结果两组患者的HBV-DNA阴转率随着治疗时间的延长逐渐增加,在各时间点的HBV-DNA阴转率差异无统计学意义(P>0.05);两组治疗1个月后TBIL、ALT、PTA与治疗前差异有统计学意义(P<0.05);两组Child-Pugh评分随着治疗时间的延长呈现下降的趋势,在各时间点的评分差异无统计学意义(P>0.05);两组患者在治疗过程中均未出现严重不良反应,两组之间安全性比较差异无统计学意义(P>0.05)。结论阿德福韦酯与拉米夫定联合应用可以弥补阿德福韦酯治疗后病毒学应答较慢的不足,也可弥补拉米夫定长期使用造成病毒耐药的不足,整体疗效与恩替卡韦单药治疗相当。
Objective To investigate clinical efficacy of adefovir dipivoxil combined with lamivudine and entecavir in the treatment of HBV cirrhosis.Methods Eighty-three patients with HBV cirrhosis in our hospital were selected and divided into two groups.The observation group （n=42） applied adefovir dipivoxil combined with lamivudine for treatment,and the control group （n=41） used entecavir only.The treatment course was 48 weeks.HBV-DNA negative rate,and liver and kidney function indicators were regular tested 8,12,24,48 weeks after treatment.Results HBV-DNA negative rate in both groups was gradually increased with the treatment time,with no statistically significant differences at each time point （P〉0.05）.TBIL,ALT,PTA in both groups one month after treatment were significantly different from those before treatment （P〈0.05）.Child-Pugh score in both groups gradually declined with the treatment time,with no statistically significant differences at each time point （P〉0.05）.There were no serious adverse reactions during treatment in both groups,and security showed no significant difference between the two groups （P〉0.05）.Conclusion Adefovir dipivoxil combined with lamivudine can compensate slower lack of virologic response and viral resistance caused by long-term using.It has corresponding efficacy with entecavir.
出处
《海南医学》
CAS
2013年第22期3303-3305,共3页
Hainan Medical Journal
