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目的观察拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床疗效。方法对临汾市传染病医院2008年至2013年收治的204例失代偿期乙型肝炎肝硬化患者的临床资料进行回顾性分析,其中经拉米夫定联合阿德福韦酯治疗的患者96例,拉米夫定治疗组50例,阿德福韦酯组58例,均在观察点48周时评价疗效,比较三组的丙氨酸氨基转换酶(ALT)复常率、HBV-DNA阴转率、HBe Ag/Hbe Ab血清学转化率。结果治疗后三组的ALT复常率、HBVDNA阴转率与治疗前相比差异均有统计学意义(P<0.05),联合组与拉米夫定组、阿德福韦酯组在ALT复常率、HBVDNA阴转率及耐药率方面相比差异均有统计学意义(P<0.05),三组HBe Ag/Hbe Ab血清转化率相比差异无统计学意义(P>0.05)。拉米夫定组和阿德福韦酯组相比ALT复常率、HBV-DNA阴转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能更好地改善失代偿期乙型肝炎肝硬化患者的肝功能,提高HBV-DNA阴转率、降低耐药率。
Objective To observe the clinical efficacy of lamivudine combined with adefovir dipivoxil in decompensated hepatitis B cirrhosis. Methods A retrospective analysis was performed on the clinical data of 204 decompensated patients with hepatitis B cirrhosis admitted from 2008 to 2013 in Linfen City Infectious Disease Hospital from 2008 to 2013. 96 patients treated with lamivudine combined with adefovir dipivoxil Cases, lamivudine treatment group 50 cases, adefovir dipivoxil group 58 cases, were observed at 48 weeks to evaluate the efficacy of alanine aminotransferase (ALT) normalization rate, HBV-DNA Negative conversion rate, HBe Ag / Hbe Ab seroconversion rate. Results There were significant differences in ALT normalization rate and HBVDNA negative conversion rate between the three groups after treatment (P <0.05), and the combination therapy with lamivudine and adefovir dipivoxil in ALT complex (P <0.05). There was no significant difference in serum HBeAg / Hbe Ab conversion rates between the three groups (P> 0.05). There was no significant difference in ALT normalization rate and HBV-DNA negative conversion rate between lamivudine group and adefovir dipivoxil group (P> 0.05). Conclusions Lamivudine combined with adefovir dipivoxil can better improve liver function, improve HBV-DNA negative conversion rate and reduce drug resistance rate in patients with decompensated hepatitis B cirrhosis.