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目的观察阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效和安全性。方法选择活动性失代偿期乙型肝炎后肝硬化患者76例,其中治疗组38例用阿德福韦酯治疗;对照组38例不做任何抗病毒及免疫调节治疗;两组均常规使用护肝和对症治疗。观察治疗后的6～12个月的临床症状、肝功能、病毒学指标的变化情况。结果治疗组的临床症状、体征、肝功能改善情况、好转率、无效率、病死率、病毒学指标HBV-DNA阴转等方面均明显优于对照组,差异均有统计学意义(P<0.01)。结论阿德福韦酯在治疗失代偿期乙型肝炎后肝硬化,能快速有效抑制HBV复制,使肝细胞炎症减缓,使肝细胞在一定程度上得到再生和修复,有明显抗肝纤维化的作用,从而改善肝功能。其疗效肯定,安全,无明显毒副作用,且病毒耐药突变率低,是有效而理想的抗病毒药物,值得临床推广应用。
Objective To observe the efficacy and safety of adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis. Methods 76 patients with active decompensated hepatitis B cirrhosis were selected. Among them, 38 patients were treated with adefovir dipivoxil in the treatment group, 38 patients in the control group were not treated with antiviral and immunomodulatory drugs, and both groups were routinely used Liver protection and symptomatic treatment. Observed after 6 to 12 months of clinical symptoms, liver function, virological changes. Results The clinical symptoms, signs, improvement of hepatic function, improvement rate, inefficiency, mortality and virological index HBV-DNA overcast in the treatment group were significantly better than those in the control group (P <0.01) ). Conclusion adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis, rapid and effective inhibition of HBV replication, so that the slow down of hepatocellular inflammation, liver cells to a certain extent, be regenerated and repaired, with significant anti-liver fibrosis The role of improving liver function. Its efficacy is affirmative, safe, no obvious side effects, and the mutation rate of virus resistance is low, which is an effective and ideal antiviral drug, which is worthy of clinical promotion and application.