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目的探究阿德福韦酯(ADV)联合拉米夫定(LAM)治疗乙肝病毒(HBV)感染后的肝硬化失代偿期的疗效和安全性。方法病例来源于陕西省安康市中心医院2010年1月至2012年9月收治确诊为乙肝肝硬化失代偿期病患112例,依照随机数字表法分为两组,每组56例,对应随机数字是奇数者为观察组,对应偶数者为对照组。对照组给予LAM治疗,观察组给予ADV联合LAM治疗,观测比较两组治疗前、治疗24周及48周时肝功能、治疗48周时Child-pugh评分及不良反应发生情况等指标。结果两组经治疗后肝功能均有显著改善(P<0.05),但观察组肝功能恢复较对照组更佳(P<0.05),差异有统计学意义;观察组治疗后Child-pugh评分与对照组比较差异有统计学意义(P<0.05);治疗48周时,观察组血清HBV DNA转阴率、HBe Ag转阴率较对照组上升明显(P<0.05),差异有统计学意义,并且两组患者治疗期间未见明显不良反应。结论 ADV联合LAM治疗乙肝肝硬化失代偿期病患疗效显著,安全性较高,能有效控制病情,临床意义重大。
Objective To investigate the efficacy and safety of adefovir dipivoxil (ADV) combined with lamivudine (LAM) in the treatment of decompensated cirrhosis after hepatitis B virus infection. Methods A total of 112 patients with decompensated hepatitis B were admitted to Ankang Central Hospital of Shaanxi Province from January 2010 to September 2012. The patients were divided into two groups according to random number table method, 56 cases in each group Random numbers are odd number for the observation group, the corresponding even number for the control group. LAM treatment control group, group administered observation LAM ADV combined treatment was observed between the two groups before treatment, treatment of liver at 24 weeks and 48 weeks treatment score and indicators Child-pugh adverse events at 48 weeks and so on. Results The liver function of the two groups was significantly improved after treatment (P <0.05), but the liver function recovery of the observation group was better than that of the control group (P <0.05), the difference was statistically significant. The Child-pugh score (P <0.05). After 48 weeks of treatment, the serum HBV DNA negative rate and HBeAg negative rate in the observation group increased significantly compared with the control group (P <0.05), the difference was statistically significant And no significant adverse reactions during the treatment of two groups of patients. Conclusion ADV combined with LAM treatment of patients with decompensated hepatitis B liver cirrhosis patients with significant efficacy, safety, can effectively control the disease, clinical significance.