论文部分内容阅读
目的探讨阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床效果。方法选取72例失代偿期乙型肝炎肝硬化患者为研究对象,按照随机、自愿的原则分为对照组和观察组,每组各36例。所有患者均给予保护肝脏及对症支持治疗,对照组在常规治疗基础上给予拉米夫定,观察组在常规治疗基础上加用阿德福韦酯,疗程均为24个月。比较两组患者治疗前后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(Tbil)变化、腹水消退情况及血清HBV-DNA的转阴率,观察治疗期间不良反应发生情况。结果治疗后两组ALT、AST和Tbil均较治疗前明显下降,腹水明显减少或消退,差异均有统计学意义(与本组治疗前相比,均P<0.05),且观察组下降更为明显(与对照组治疗后相比,均P<0.05)。观察组治疗6个月和12个月后HBV-DNA转阴率明显高于对照组,差异均有统计学意义(均P<0.05)。两组患者均未发生严重不良反应。结论阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者临床效果确切,安全性好,值得推广应用。
Objective To investigate the clinical effect of adefovir dipivoxil on decompensated hepatitis B cirrhosis. Methods Seventy-two patients with decompensated hepatitis B cirrhosis were randomly divided into control group and observation group with 36 cases in each group. All patients were given liver protection and symptomatic and supportive treatment. The control group was given lamivudine on the basis of routine treatment. The observation group was given adefovir dipivoxil on the basis of routine treatment. The course of treatment was 24 months. The changes of ALT, AST, Tbil, regression of ascites and the negative rate of serum HBV-DNA in both groups were compared before and after treatment to observe the adverse reactions during the treatment. Results After treatment, the ALT, AST and Tbil in both groups were significantly lower than those before treatment, and the ascites decreased or disappeared significantly (all P <0.05 compared with those before treatment), and the decrease in the observation group was more Obvious (compared with the control group after treatment, all P <0.05). The negative rates of HBV DNA in observation group were significantly higher than those in control group at 6 and 12 months after treatment (all P <0.05). No serious adverse reactions occurred in both groups. Conclusion adefovir dipivoxil treatment of decompensated hepatitis B patients with cirrhosis clinical effect is exact, safe, it is worth promoting the application.