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目的观察拉米夫定联合阿德福韦酯治疗活动性乙型肝炎肝硬化的临床疗效。方法将96例活动性乙型肝炎肝硬化患者分成A、B、C3组,每组32例。A组采用拉米夫定联合阿德福韦酯治疗,B组予拉米夫定治疗,C组予阿德福韦酯治疗,疗程均为48周。观察治疗中3组ALT复常率、HBVDNA阴转率、HBeAg/抗HBe血清转换率等变化情况,及随访2年的耐药发生率。结果 A组HBVDNA转阴率在第12周、24周优于C组(P<0.05);ALT复常率第12周优于B组(P<0.05)、C组(P<0.01);第24周优于C组。随访2年,A组耐药发生率最低。结论拉米夫定与阿德福韦酯联合用药较单独用药疗效更佳。
Objective To observe the clinical efficacy of lamivudine combined with adefovir dipivoxil in the treatment of active hepatitis B cirrhosis. Methods 96 cases of active hepatitis B cirrhosis patients were divided into A, B, C3 group, 32 cases in each group. Group A received lamivudine combined with adefovir dipivoxil, group B received lamivudine, and group C received adefovir dipivoxil for 48 weeks. The changes of ALT normalization rate, HBVDNA negative rate and HBeAg / anti-HBe seroconversion rate were observed and the incidence of drug resistance after 2 years of follow-up was observed. Results The negative rate of HBVDNA in group A was better than that in group C at week 12 and 24 (P <0.05). The rate of normal ALT at week 12 was superior to group B (P <0.05) and group C (P <0.01) 24 weeks better than C group. After 2 years of follow-up, the incidence of drug resistance in group A was the lowest. Conclusion lamivudine and adefovir dipivoxil combination therapy is better than alone.