摘要
目的:观察拉米夫定联合阿德福韦酯治疗乙型肝炎病毒(HBV)肝硬化的临床疗效和安全性。方法:将符合标准的142例HBV肝硬化患者随机均分为阿德福韦酯组、拉米夫定组和联合用药组。所有患者均给予常规治疗。在此基础上,阿德福韦酯组患者给予阿德福韦酯胶囊10 mg,口服,qd;拉米夫定组患者给予拉米夫定片100 mg,口服,qd;联合用药组患者给予阿德福韦酯+拉米夫定。各组患者疗程均为12个月。观察各组患者的临床疗效,治疗前后的肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)],肝脏储备功能量化评分(Child-Pugh)分级,HBV脱氧核糖核酸(HBV-DNA)阴转率及转阴时间,并记录不良反应发生情况。结果:治疗后,各组患者肝功能指标均显著低于同组治疗前,且联合用药组低于阿德福韦酯组和拉米夫定组,差异均有统计学意义(P<0.05);联合用药组患者总有效率、HBV-DNA阴转率、Child-Pugh A级患者例数均显著高于阿德福韦酯组和拉米夫定组,HBV-DNA转阴时间、Child-Pugh B、C级患者例数均显著低于阿德福韦酯组和拉米夫定组,差异均有统计学意义(P<0.05)。各组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:拉米夫定联合阿德福韦酯治疗HBV肝硬化较单用拉米夫定或阿德福韦酯疗效更显著,且安全性相似。
OBJECTIVE：To observe the clinical efficacy and safety of lamivudine combined with adefovir dipivoxil in the treatment of HBV-cirrhosis.METHODS：Totally 142 patients with HBV-cirrhosis were randomly divided into adefovir dipivoxil group,lamivudine group and combination group.All patients were given routine treatment.Based on it,the patients in adefovir dipivoxil group were orally given adefovir dipivoxil capsules 10 mg,qd;patients in lamivudine group were given Lamivudine tablets 100 mg,qd;and patients in combination group were given adefovir dipivoxil and lamivudine.The course of 3 groups was 12 months.The clinic data was observed,including clinical efficacy,liver function indexes（TBIL,ALT,AST）],Child-Pugh grades,negative rate and negative time of HBV-DNA before and after treatment.ADR was recorded.RESULTS：After treatment,the liver function indexes in 3 groups were significantly lower than before and combination group was lower than adefovir dipivoxil group and lamivudine group,with significant differences（P〈0.05）.The total effective rate and negative rate of HBV-DNA in combination group were significantly higher than adefovir dipivoxil group and lamivudine group,patients with Child-Pugh Grade A were significantly more than adefovir dipivoxil group and lamivudine group,and negative time of HBV-DNA and patients with Child-Pugh Grade B and C were significantly less than adefovir dipivoxil group and lamivudine group（P〈0.05）.There was no significant difference in the incidence of adverse reactions in 3 groups（P〉0.05）.CONCLUSIONS：Lamivudine combined with adefovir dipivoxil has better efficacy than only lamivudine or adefovir dipivoxil in the treatment of HBV-cirrhosis with similar safety.
出处
《中国药房》
CAS
北大核心
2015年第15期2072-2074,共3页
China Pharmacy
