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目的观察阿德福韦酯联合拉米夫定治疗乙型肝炎失代偿期肝硬化的疗效和不良反应。方法 76例伴有乙型肝炎病毒(HBV)复制的乙型肝炎失代偿期肝硬化患者,随机均分为阿德福韦酯联合拉米夫定治疗组和单用阿德福韦酯对照组,每12周评价1次,疗程均为48周。结果两组在治疗24周时,肝功能指标和Child-Pugh评分均明显好转,而治疗组优于对照组,差异有统计学意义(P<0.05),在治疗48周时,治疗组仍优于对照组,但差异无统计学意义(P>0.05)。两组治疗后HBV-DNA水平均明显下降,差异有统计学意义(P<0.05)。治疗组治疗24周及48周时,HBV-DNA转阴率分别是76.3%(29/38)和100.0%(38/38),对照组分别是52.6%(20/38)和78.9%(30/38),治疗组转阴率均显著优于对照组,差异有统计学意义(P<0.05)。结论阿德福韦酯联合拉米夫定治疗乙型肝炎病毒所致失代偿期肝硬化,可快速抑制病毒复制和改善肝功能,安全性、耐受性好,疗效优于单用阿德福韦酯。
Objective To observe the efficacy and adverse reactions of adefovir dipivoxil combined with lamivudine in the treatment of decompensated cirrhosis of the liver. Methods A total of 76 patients with hepatitis B decompensated cirrhosis accompanied by hepatitis B virus (HBV) were randomly divided into adefovir dipivoxil combined with lamivudine treatment group and adefovir dipivoxil alone Group, every 12 weeks evaluation 1, treatment for 48 weeks. Results At 24 weeks of treatment, the liver function indexes and Child-Pugh scores improved significantly in both groups, but the difference between the two groups was statistically significant (P <0.05). At 48 weeks, the treatment group was still superior In the control group, but the difference was not statistically significant (P> 0.05). After treatment, the levels of HBV-DNA in both groups were significantly decreased, the difference was statistically significant (P <0.05). At 24 and 48 weeks of treatment, the negative rates of HBV DNA in the treatment group were 76.3% (29/38) and 100.0% (38/38) respectively, while those in the control group were 52.6% (20/38) and 78.9% (30.9% / 38). The negative conversion rate of the treatment group was significantly better than that of the control group, the difference was statistically significant (P <0.05). Conclusion adefovir dipivoxil combined with lamivudine treatment of decompensated cirrhosis caused by hepatitis B virus can rapidly inhibit viral replication and improve liver function, safety, well tolerated, the effect is better than single Ade Fu Wei ester.