拉米夫定与阿德福韦酯联合治疗代偿期乙型肝炎肝硬化的临床效果研究

目的探讨代偿期乙型肝炎肝硬化患者采用拉米夫定与阿德福韦酯联合治疗的临床效果。方法选取来我院治疗的150例代偿期乙型肝炎肝硬化患者作为研究对象，将其按照治疗的方法分为观察组和对照组各75例。观察组给予拉米夫定及阿德福韦酯联合治疗，对照组给予阿德福韦酯治疗，对两组患者的治疗结果进行比较。结果①观察组患者第4、12周与对照组比较具有明显较高的HBV—DNA阴转率（P〈0．05）；②两组患者治疗12周及24周与治疗前比较，ALT、PT、TBiL显著降低，ALB显著升高（P〈0．05）；以上观察指标治疗12周在两组间具有显著性差异（P〈0．05）。③两组患者治疗24周后，HA、PⅢNP、Ⅳ型胶原及LN水平与治疗前比较均明显下降（P〈0．05），与对照组治疗后比较，观察组降低的幅度更大（P〈0．05）。结论代偿期乙型肝炎肝硬化患者采用拉米夫定与阿德福韦酯联合治疗能够收到较好的临床效果，可以在临床推广应用。

Study on clinical effect of compensated cirrhosis of hepatitis B treated with lamivudine and adefovir dipivoxil

Objective To investigate the clinical effect of compensated cirrhosis of hepatitis B treated with lamivudine and adefovir dipivoxil. Methods We collected 150 patients with compensated cirrhosis of hepatitis B in our hospital, they were divided into observation group and control group according to treatment methods, there were 75 cases in each group.The observation group was treated with lamivudine and adefovir dipivoxil,the control group was treated with adefovir dipivoxil. The effect of two groups were compared. Results （1）HBV-DNA negative conversion rate in observation group after treated 4 weeks and 12 weeks was significantly higher than that in the control group （P 〈 0.05） ; （2）ALT,PT,TBiL in two groups after treated 12 weeks and 24 weeks were significantly decreased than before treated, ALB was significantly increased than before treated （P 〈 0.05）;the observation indexes all of above after treated 12 weeks had significant differences between two groups （P 〈 0.05）. （3）HA, P m NP, collagen type IV and LN levels in two groups after 24 weeks of treatment were obviously decreased than before treatment（P 〈 0.05 ）;the observation group were reduced significantly than control group after treatment （P 〈 0.05）. Conclusion Patients with compensated cirrhosis of hepatitis B treated with lamivudine and adefovir dipivoxil combined treatment can receive good clinical effect, can be widely used in clinical practice.