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目的比较两种抗病毒药物治疗乙肝后肝硬化的疗效。方法对2014年7月-2015年2月新乡市传染病医院收治的60例肝硬化患者随机分为两组,对照组(阿德福韦组32例),观察组(恩替卡韦组28例)。比较两组治疗前后肝功能,血清HBV-DNA阴转率,总胆红素(TBIL)、白蛋白(ALB)、丙氨酸氨基转化酶(ATL)、凝血酶原活动度(PTL),ChildPugh分级评分的变化。结果治疗36周后,对照组和观察组肝功能明显改善(P<0.05),但是它们之间差异无统计学意义(P>0.05);对照组转阴率12周38.46%,24周76.92%,36周88.46%;观察组转阴率12周88.89%,24周92.59%,36周96.30%。在12周时观察组转阴率高于对照组差异有统计学意义(P<0.05),观察组总胆红素(TBIL)、白蛋白(ALB)、丙氨酸氨基转化酶(ATL)、凝血酶原活动度(PTL)指标优于对照组,差异有统计学意义(P<0.05);Child-Pugh分级评分对照组和观察组均下降,但是两组前后差异无统计学意义(P>0.05)。结论对照组和观察组肝功能改善,Child-Pugh评分下降,有利于肝硬化治疗,观察组疗效更佳。
Objective To compare the curative effects of two antiviral drugs on posthepatitic cirrhosis. Methods Sixty patients with cirrhosis who were admitted to Xinxiang infectious disease hospital from July 2014 to February 2015 were randomly divided into two groups: control group (adefovir group, 32 cases) and observation group (entecavir group, 28 cases). The changes of liver function, serum HBV-DNA negative rate, total bilirubin, ALB, ALT, PTL, Changes in graded scores. Results After 36 weeks of treatment, the liver function of the control group and the observation group was significantly improved (P <0.05), but there was no significant difference between them (P> 0.05); the control group had a negative conversion rate of 38.46% at 12 weeks and 24 weeks at 76.92% , 88.46% in 36 weeks; the negative rate of observation group was 88.89% in 12 weeks, 92.59% in 24 weeks and 96.30% in 36 weeks. At 12 weeks, the rate of negative conversion in the observation group was significantly higher than that in the control group (P <0.05). The total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ATL) Prothrombin activity index (PTL) was superior to control group, the difference was statistically significant (P <0.05); Child-Pugh grading score decreased in both control group and observation group, but there was no significant difference between the two groups (P> 0.05). Conclusion The liver function and the Child-Pugh score of the control group and the observation group are decreased, which are good for the treatment of liver cirrhosis. The observation group has better effect.