拉米夫定联合恩替卡韦治疗乙型肝炎相关肝硬化的 长期疗效与安全性分析

目的 探讨乙型肝炎相关肝硬化采用拉米夫定联合恩替卡韦治疗的长期疗效与安全性。方法 选取2017年6月~2019年1月我院收治的150例乙型肝炎相关肝硬化患者，随机分为对照组和观察组，每组75例。对照组采用恩替卡韦治疗，观察组采用拉米夫定联合恩替卡韦治疗。采用荧光定量聚合酶链反应法测量患者治疗6个月及治疗12个月的乙肝病毒基因转阴率，评估患者临床总有效率，比较谷丙转氨酶（ALT）、谷草转氨酶（AST）及总胆红素（TBIL）水平，观察并发症发生情况。结果 观察组治疗6个月及治疗12个月的乙肝病毒基因转阴率分别为60.00%和98.67%，均高于对照组的45.33%和85.33%，差异具有统计学意义（P＜0.05）；治疗后，观察组的治疗有效率高于对照组（96.00% vs 81.33%），差异具有统计学意义（P＜0.05）；治疗后，两组患者的ALT、AST及TBIL水平低于治疗前，且观察组的ALT、AST及TBIL水平较对照组下降幅度更大（P＜0.05）；观察组患者并发症发生率与对照组比较（4.00% vs 2.67%），差异无统计学意义（P＞0.05）。结论 针对乙型肝炎相关肝硬化患者，采用拉米夫定联合恩替卡韦治疗长期疗效更佳，改善肝功能，安全有效。

Long-term Efficacy and Safety of Lamivudine Combined with Entecavir in the Treatment of Hepatitis B-related Cirrhosis

Abstract:Objective To investigate the long-term efficacy and safety of lamivudine combined with entecavir in the treatment of patients with hepatitis B-related cirrhosis. Methods A total of 150 patients with hepatitis B-related cirrhosis admitted to our hospital from June 2017 to January 2019 were randomly divided into control group and observation group, with 75 cases in each group. The control group was treated with entecavir alone, and the observation group was treated with lamivudine plus entecavir. Fluorescence quantitative polymerase chain reaction (PCR) was used to measure the rate of hepatitis B virus gene transfusion in patients treated for 6 months and 12 months, and the total clinical effectiveness was evaluated. The alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) was compared, the occurrence of complications was observed.Results The conversion rate of hepatitis B virus gene in the observation group was 60.00% and 98.67% for 6 months and 12 months, respectively, which were higher than that of the control group 45.33% and 85.33%, the difference was statistically significant (P<0.05); After treatment, the effective rate of the observation group was higher than that of the control group (96.00% vs 81.33%), the difference was statistically significant (P<0.05). After treatment, the ALT, AST and TBIL levels in the two groups were lower than the treatment.The ALT, AST and TBIL levels in the observation group were more significant than those in the control group (P<0.05). The complication rate in the observation group was compared with the control group (4.00% vs 2.67%),the difference was not statistically significant (P>0.05). Conclusion For patients with hepatitis B-related cirrhosis, lamivudine combined with entecavir has better long-term efficacy and improved liver function, which is safe and effective.