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目的探讨阿德福韦酯片联合替比夫定治疗乙肝肝硬化的临床效果。方法选取2012年6月—2014年8月于邯郸市第二医院接受治疗的乙肝肝硬化患者120例,按随机数表法将患者分为对照组与观察组,各60例。对照组患者予以替比夫定治疗,观察组在对照组基础上加用阿德福韦酯片治疗。观察两组患者治疗前、治疗后48h肝功能与肝纤维化指标〔天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBi L)、层粘连蛋白(LN)、透明质酸(HA)〕,HBV转阴率与乙型肝炎E抗原(HBe Ag)血清转换率。结果治疗前两组患者AST、ALT、TBi L、LN、HA比较,差异无统计学意义(P<0.05),治疗后观察组患者组AST、ALT、TBi L、LN、HA低于对照组,差异有统计学意义(P<0.05);观察组患者HBV转阴率高于对照组,HBe Ag血清转换率低于对照组,差异均有统计学意义(P<0.05);两组患者均未出现严重不良反应。结论阿德福韦酯片联合替比夫定治疗乙肝肝硬化的临床效果显著,且不良反应小。
Objective To investigate the clinical effect of adefovir dipivoxil and telbivudine in the treatment of hepatitis B cirrhosis. Methods From June 2012 to August 2014, 120 patients with hepatitis B cirrhosis were treated in the Second Hospital of Handan City. The patients were divided into control group and observation group according to random number table method, and each group had 60 cases. Patients in the control group were treated with telbivudine. The observation group was treated with adefovir dipivoxil on the basis of the control group. The liver function and hepatic fibrosis indicators (AST, ALT, TBiL, (LN), hyaluronic acid (HA)], HBV negative rate and hepatitis B E antigen (HBeAg) seroconversion rate. Results There was no significant difference in AST, ALT, TBiL, LN and HA between the two groups before treatment (P <0.05). After treatment, the levels of AST, ALT, TBiL, LN and HA in the observation group were lower than those in the control group (P <0.05). The negative rate of HBV in the observation group was higher than that in the control group, and the serum HBeAg conversion rate was lower in the observation group than in the control group (P <0.05). There was no significant difference between the two groups Serious adverse reactions. Conclusion adefovir dipivoxil tablets combined with telbivudine in the treatment of hepatitis B cirrhosis has a significant clinical effect, and adverse reactions.