拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化

目的：探讨研究拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床疗效及安全性。方法：选取本院2012年6月-2013年5月接诊的失代偿期乙型肝炎肝硬化患者56例，按照随机数字表法分为试验组和对照组，两组在常规的保肝、利尿、补充白蛋白等方面进行对症治疗的基础上，试验组（28例）给予拉米夫定联合阿德福韦酯治疗，对照组（28例）给予拉米夫定治疗，疗程为24周，治疗期间监测患者用药安全性，观察比较两组的临床疗效。结果：经过治疗后，两组AST、ALT、总胆红素水平均显著下降，与治疗前比较差异均有统计学意义（P〈0.05）；且治疗后试验组的AST、ALT、总胆红素水平较对照组更低，比较差异均有统计学意义（P〈0.05）。随着治疗时间的延长，两组患者Child-Pugh评分均随之下降，但试验组较对照组下降更为明显。治疗24周后，两组Child-Pugh评分比较差异有统计学意义（P〈0.05）。试验组HBV-DNA转阴率为51.85%；对照组为38.46%，说明试验组治疗效果优于对照组。结论：拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床疗效好，安全性高，值得临床推广应用。

The Clinical Effects of Lamivudine and Adefovir Dipivoxil in Treatment of Hepatic B Liver Cirrhosis in Decompensated Period

Objective：To evaluate the clinical efficacy and safety of lamivudine and adefovir dipivoxil in treatment of hepatic B liver cirrhosis in decompensated period. Method：Fifty-six patients with hepatic B liver cirrhosis in decompensated period in the hospital from June 2012 to May 2013 were randomly divided into the experimental group and the control group. All the patients were given the treatment of normal liver protection,such as diuresis and albumin supplementation. In addition, the experimental group was given lamivudine and adefovir dipivoxil,the control group was only given lamivudine.The adverse events would be recorded during the study after treatment of 24 weeks. The clinical curative effects of two groups were observed and compared. Result：After treatment,AST,ALT,total bilirubin levels of both groups were significantly declined,there were all significant difference compared with before treatment（P〈0.05）. And the experimental group after treatment of AST,ALT, total bilirubin levels were lower than the control group,and the difference between the two groups were all statistically significant （P〈0.05）. The Child-Pugh score were decrease as the extension of treatment time in two groups,and the experimental group decreased more obvious than the control group. The difference of Child-Pugh score after treatment 24 weeks between the two groups was statistically significant（P〈0.05）. The negative conversion ratio of HBV-DNA of the control group was 38.46%while the treatment group was 51.85%after treatment,so the clinical effect of the treatment group was better than the control group. Conclusion：Lamivudine combined with adefovir dipivoxil in treatment of hepatic B liver cirrhosis in decompensated period has good clinical curative effects. It has highly safety,worthy of clinical popularization and application.