阿德福韦酯联合拉米夫定与恩替卡韦单药治疗乙肝肝硬化的效果

目的分析阿德福韦酯联合拉米夫定与恩替卡韦单药治疗乙型病毒性肝炎(乙肝)肝硬化的效果。方法68例乙肝肝硬化患者,依据随机数字表法分为对照组及观察组,每组34例。对照组口服阿德福韦酯联合拉米夫定治疗,观察组服用恩替卡韦治疗。12周后复查,比较两组患者的治疗效果、不良反应发生情况及治疗前后的肝功能指标凝血酶原活动度(PTA)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)]和肝纤维化指标Ⅳ型胶原(CⅣ)、层粘连蛋白(LN)、Ⅲ型前胶原氨基端肽(PⅢNP)、透明质酸(HA)]。结果治疗后,两组PTA、AST、TBIL、ALT和CⅣ、LN、PⅢNP、HA水平均较治疗前改善,且观察组改善程度优于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率91.18%高于对照组的70.59%,差异有统计学意义(P<0.05)。观察组不良反应发生率为2.94%(1/34),低于对照组的20.59%(7/34),差异有统计学意义(P<0.05)。结论阿德福韦酯联合拉米夫定与恩替卡韦单药治疗乙肝肝硬化效果存在差异,恩替卡韦单药治疗的效果和安全性更好,可缓解患者临床症状,促进患者肝功能和肝纤维化的改善,值得推广和应用。

Effect of adefovir dipivoxil combined with lamivudine and entecavir monotherapyin the treatment of hepatitis B cirrhosis

Objective To analyze the effect of adefovir dipivoxil combined with lamivudine and entecavir monotherapy in the treatment of hepatitis B cirrhosis.Methods A total of 68 patients with hepatitis B cirrhosis were divided into control group and observation group according to random numerical table,with 34 cases in each group.The control group was treated with oral administration of adefovir dipivoxil combined with lamivudine,and the observation group was treated with oral administration of entecavir.The therapeutic effects,occurrence of adverse reactions,and liver function indicatorsprothrombin activity(PTA),aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT)]and liver fibrosis indicatorstypeⅣcollagen(CⅣ),laminin(LN),typeⅢprocollagen amino peptide(PⅢNP),hyaluronic acid(HA)]before and after treatment were compared between the two groups.Results After treatment,the levels of PTA,AST,TBIL,ALT,CⅣ,LN,PⅢNP and HA of the two groups were improved compared with those before treatment,and the improvement of the observation group was better than that of the control group.All the difference was statistically significant(P<0.05).The total effective rate 91.18%of the observation group was higher than 70.59%of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of the observation group was 2.94%(1/34),which was lower than 20.59%(7/34)of the control group,and the difference was statistically significant(P<0.05).Conclusion There are differences in the effect of adefovir dipivoxil combined with lamivudine and entecavir monotherapy in the treatment of hepatitis B cirrhosis.Entecavir monotherapy has better effect and safety,which can relieve the clinical symptoms of patients,promote the improvement of liver function and liver fibrosis,and is worthy of promotion and application.