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目的探讨阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化的临床效果。方法选取乙型肝炎肝硬化患者130例,随机分成两组,在一般治疗的基础上,对照组采取阿德福韦酯治疗;观察组采用阿德福韦酯联合拉米夫定治疗。观察并比较两组患者肝、肾功能、血清HBV-DNA阴转率、HBeAg转阴率、肝脏Child-pugh评分与药物不良反应。结果治疗后观察组的Child-Pugh评分、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、层粘连蛋白、透明质酸较对照组下降更明显,P<0.05,差异有统计学意义;观察组的血清HBV-DNA阴转率、HbeAg阴转率和HbeAg/抗-HbeAb血清转换率显著高于对照组,P<0.05,结果有统计学意义。结论阿德福韦酯联合拉米夫定治疗乙型肝炎肝硬化可明显改善患者肝功能,降低耐药发生比例,减缓肝纤维化的速度,不良反应少,有效降低了肝癌发生率及病死率。
Objective To investigate the clinical efficacy of adefovir dipivoxil combined with lamivudine in the treatment of hepatitis B cirrhosis. Methods 130 patients with hepatitis B cirrhosis were randomly divided into two groups. On the basis of general treatment, the control group was treated with adefovir dipivoxil. The observation group was treated with adefovir dipivoxil combined with lamivudine. The liver and renal function, serum HBV-DNA negative rate, HBeAg negative rate, liver Child-pugh score and drug adverse reactions were observed and compared between the two groups. Results After treatment, Child-Pugh scores, alanine aminotransferase, aspartate aminotransferase, laminin and hyaluronic acid in the observation group decreased more significantly than those in the control group (P <0.05), and the difference was statistically significant. The serum HBV-DNA negative rate, HbeAg negative rate and HbeAg / anti-HbeAb seroconversion rate in the observation group were significantly higher than those in the control group (P <0.05). The results were statistically significant. Conclusion Adefovir dipivoxil combined with lamivudine treatment of hepatitis B cirrhosis can significantly improve liver function, reduce the incidence of drug resistance, reduce the rate of liver fibrosis, fewer adverse reactions, effectively reducing the incidence of liver cancer and mortality .