阿德福韦酯和恩替卡韦治疗活动性肝硬化患者48周的临床疗效观察

目的观察阿德福韦酯和恩替卡韦治疗活动性肝硬化患者48周的疗效和不良反应。方法将60例活动性肝硬化患者，随机分为阿德福韦酯组30例，给予阿德福韦酯10mg／d；恩替卡韦组30例，给予恩替卡韦0．5mg／a，观察期均为48周。均给予常规护肝及支持、对症治疗。观察两组患者的肝肾功能、血清学标志物、HBVDNA、肝纤维化标志物及药物不良反应情况。结果两组患者肝功能各项指标的复常率、转阴率、HBeAg转阴率及HBeAg／抗HBe转换率均随着治疗疗程的延长而增加，但两组比较，差异无统计学意义。两组患者均未发现药物相关的肾功能损害。两组中各有2例患者出现轻度不良反应，但均能耐受。结论活动性肝硬化患者48周的抗病毒治疗，恩替卡韦的疗效与安全性均与阿德福韦酯相似，而病毒转阴率较阿德福韦酯高。

A Clinical Study of Adefovir Dipivoxil,Endecavir Treatment for Patients with Active Cirrhosis

Objective To evaluate the efficacy and safety of 48 weeks adefovir dipivoxil(ADV),endecavir treatment for patients with active cirrhosis.Methods 60 patients with active cirrhosis were randomly divided into two groups.An adefovir dipivoxil(ADV)group:30 patients treated with 10 mg of ADV a day;and an endecavir(ETV)group:30 patiens treated with 0.5mg of ETV a day.The course of treatment lasted 48 weeks.Serum levels of alanine amino transferase(ALT),aspartate amino transferase(AST),ALB,TBiL,HBeAg,HBV DNA,PCIII,IVC,LN,and HA,renal function and drug adverse reactions during the treatment of the two groups were checked,compared and analyzed.Result The ratios of recovery for fiver functions and the negativity rate of HBV DNA,HBeAg,included sero-conversion rate of HBeAg/HBeAb,were increased with prolongation of the treatment period;However the differences between the two groups were not significant.Two groups were not suffered from virus variation.No drug related renal function impairment was found during the treatment.Two patients of each group had adverse drug reactions but both were mild.Conclusion The efficacy and safety of adefovir dipivoxil and endecavir treatment for the above patients were similar,but the ratio of negativity rate of HBV DNA is lower in the ETV treatment group.