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目的比较恩替卡韦(ETV)与阿德福韦酯(ADV)联合拉米夫定(LAM)治疗乙型肝炎肝硬化失代偿期患者的疗效.方法57例失代偿期乙型肝炎肝硬化被随机分为 A、B 两组.其中 A 组29例接受 ETV 抗病毒治疗,B 组28例接受 ADV+LAM 抗病毒治疗,观察治疗前后患者的临床症状、肝、肾功能、病毒学标志物变化及 Child-Paugh 评分.结果54例患者按要求完成治疗,其中 A 组1例,B 组2 例未完成治疗而列为失败.治疗结束后2组在的肝功能得到明显改善, Child-Paugh 评分明显下降,与治疗前相比差异显著(p0.05).治疗结束后 A 组患者的 HBV-DNA 阴转率、HBeAg 阴转率及 HBeAg 血清学转换率均高于 B 组,但2组比较无显著性差异(p>0.05).结论 ETV 与 LAM+ADV 治疗失代偿期乙型肝炎肝硬化均能明显改善肝功能,不同程度地逆转肝硬化,疗效确切.“,”Objective To compare the efficacy of Entecavir(ETV) and lamivudine(LAM) combination therapy with Adefovir Dipivoxil(ADV) for patients with hepatitis B virus(HBV)-related decompensated cirrhosis. Methods Fifty-seven patients of HBV-related decompensated cirrhosis were divided in A Group(29 cases) and B group(28 cases).The patients in A group received ETV and B Group received LAM combined with ADV.The clinical symptoms,Liver and kidney function,HBV-DNA,HBeAg/antiHBe or Child-Pugh degree scores were detected before and after treatments. Results 54 cases completed the whole course of treatment except for 3 cases(one in Group A and two in Group B).Compared with pre-treatment,After the treatment, liver function was improved ,Child-Pugh degree scores of the two groups decreased, while the comparison between the two group after the treatment was not significantly different(p>0.05). After the treatment,HBV-DNA negative conversion,portion of HBeAg loss rate and HBeAg seroconversion rate was higher in A Group than B Group,But the comparison between the two group was not significantly different(p>0.05).Conclusion ETV and LAM combined with ADV have curative effect on HBV-related decompensated cirrhosis ,and they can not only improve liver function ,but also change over the cirrhosis at different degrees.