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目的观察阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化的疗效及其对血浆内皮素的影响。方法选取医院乙型肝炎肝硬化患者100例,根据治疗方法的不同分为观察组和对照组各50例,观察组给予阿德福韦酯联合拉米夫定治疗,对照组给予单一阿德福韦酯治疗。比较2组患者临床疗效、治疗前后血浆内皮素(ET)及血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、透明质酸(HA)、层黏蛋白(LN)水平。结果观察组总有效率为98.0%高于对照组的80.0%,差异有统计学意义(P<0.05)。2组治疗前血浆ET、血清ALT和AST比较差异均无统计学意义(P>0.05);治疗后2组患者血浆ET、血清ALT和AST均明显下降(P<0.05),且观察组低于对照组(P<0.05)。2组患者治疗前HA和LN水平比较差异无统计学意义(P>0.05);治疗后2组HA均明显降低(P<0.05),且观察组低于对照组(P<0.05);2组LN值均升高(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化的临床疗效显著,可显著改善患者血浆ET、肝功能及预后,值得临床推广应用。
Objective To observe the curative effect of adefovir dipivoxil combined with lamivudine on hepatitis B cirrhosis and its effect on plasma endothelin. Methods 100 cases of hepatitis B cirrhosis were selected in the hospital. According to the different treatment methods, 50 cases were divided into observation group and control group. The observation group was treated with adefovir dipivoxil combined with lamivudine, while the control group was given single adefovir Wei ester treatment. The clinical effects of two groups of patients were compared. The levels of plasma endothelin (ET), serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA), laminin )Level. Results The total effective rate in the observation group was 98.0%, which was significantly higher than that in the control group (80.0%, P <0.05). There was no significant difference in plasma ET, serum ALT and AST between the two groups before treatment (P> 0.05). After treatment, plasma ET, serum ALT and AST were significantly decreased (P <0.05), and the observation group was lower than Control group (P <0.05). There was no significant difference in the levels of HA and LN between the two groups before treatment (P> 0.05). The HA in two groups were significantly decreased (P <0.05) and the observation group was lower than the control group (P <0.05) LN value were increased (P <0.05), but there was no significant difference between the two groups (P> 0.05). Conclusion adefovir dipivoxil combined with lamivudine treatment of hepatitis B cirrhosis significant clinical effect, can significantly improve the patient’s plasma ET, liver function and prognosis, worthy of clinical application.