耐阿德福韦酯乙肝肝硬化的治疗研究

目的观察阿德福韦酯耐药乙肝肝硬化患者的抗病毒疗效。方法阿德福韦酯耐药乙肝肝硬化患者62例，随机分为治疗纽32例与对照组30例，治疗组给予阿德福韦酯10mg，每天1次顿服同时给予拉米夫定100mg，每天1次顿服，疗程2年；对照组给予恩替卡韦0．5mg，每天1次顿服，疗程2年。结果治疗组用药1年和2年后HBV—DNA阴转率、HBeAg阴转率、Child—Pugh评分分别与对照纽比较差异无统计学意义（P〉0．05）；治疗组疗程结束后Child—Push评分与治疗前差异有统计学意义（P〈0．01）；对照组疗程结束后Child-Pugh评分与治疗前差异有统计学意义（P〈0．01）；治疗组ALT复常时间与对照组差异有统计学意义（P〈0．05），疗程结束治疗组ALT复常率与对照组差异无统计学意义（P〉0．05）。结论阿德福韦酯联合拉米夫定或单用恩替卡韦治疗阿德福韦酯耐药乙肝肝硬化安全有效。

Anti-virus Therapy of Liver Cirrhosis after Chronic Hepatitis B in Patients with Adefovir Dipivoxil Resistance

Objective To investigate the therapeutic efficacies of anti-virus drugs on liver cirrhosis after chronic hepatitis B in patients with adefovir dipivoxil resistant. Methods Sixty-two of liver cirrhosis after chronic hepatitis B with adefovir dipivoxil resistant were randomly divided into two groups：32 patients in group I were administrated with adefovir dipivoxil lOmg once a day and lamivudine 100 mg once a day for 2 years;30 patients in group II were only taken entecavir 0.5 mg once a day for 2 years. Results The negative rate of HBV-DNA and HbeAg, and Child-Pugh score had not statistical difference between the two groups after 1 year and 2 years;there was statistically significance in Child-Pugh score of group I before and after treatment, it was the same clinical status with group II;the time of ALT recovery in group I had significant difference from that in groupII;As for the ALT recovery rate, there was no significant difference between the two groups. Conclusion Adefovir dipivoxil combined with lamivudine or only entecavir are effective and safe for the treatment of liver cirrhosis after chronic hepatitis B in patients with adefovir dipivoxil resistant.