回顾性分析拉米夫定联合阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者的临床疗效

摘要

目的：探究拉米夫定联合阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者的临床疗效。方法回顾性分析2014年1月～2015年1月收治的HBeAg阳性失代偿期乙肝肝硬化患者，共100例，将给予拉米夫定初始治疗耐药后加用阿德福韦酯挽救治疗的50名患者作为对照组，同时选取给予拉米夫定加阿德福韦酯初始联合治疗的患者50例，作为观察组，比较分析2组治疗的临床疗效。结果观察组患者治疗后HBeAg血清学转阴率26.00％显著高于对照组4.00％（ P＜0.05）；观察组患者治疗后12周（9.63±1.42）、24周（8.57±1.45）、48周（7.43±1.57） Child-Pugh分级评分分数显著低于对照组（9.74±1.21）、（9.45±1.33）、（8.57±1.04）（P＜0.05）；观察组患者治疗后血清中HBV-DNA载量（2.23±1.25）显著低于对照组（5.18±1.63），且观察组治疗后（2.23±1.25）血清中HBV-DNA载量显著低于治疗前（6.47±1.55）（P＜0.05）。结论治疗HBeAg阳性失代偿期乙肝肝硬化患者采用初始联合拉米夫定和阿德福韦酯治疗，临床效果显著，HBeAg血清学转阴率高，且Child-Pugh分级评分分数降低，改善肝脏储备功能，血清中HBV-DNA载量降低。%Objective To explore the combination of lamivudine and adefovir dipivoxiltreatment in HBeAg positive patients with inappropriate timing of decompensated hepatitis B cirrhosis.Methods Make a retrospective analysis of HBeAg positive patients with decompensated hepatitis B cirrhosis of the liver our hospital in 2014 January ~2015 January were,100 cases of initial treatment, 50 patients given lamivudine plus adefovir dipivoxil resistance as control group,50 cases patients given lamivudine plus adefovir dipivoxil combined as the observation group, compared two groups of clinical curative effect of treatment.Results Observation group after treatment in patients with HBeAgseroconversion rate of 26.00% was significantly higher than that in control group 4.00% (P<0.05);after 12 weeks of treatment in the observation group (9.63 ±1.42), 24 weeks(8.57 ±1.45), 48 weeks(7.43 ±1.57) Child-Pugh grading score was significantly lower than the control group(9.74 ±1.21),(9.45 ±1.33)(8.57 ±1.04)(P <0.05); level of HBV-DNA after treatment in the observation group (2.23 ±1.25) was significantly lower than that of the control group(5.18 ± 1.63), and the Patients in the observation group (2.23 ±1.25)HBV-DNA load in serum was significantly lower than that before treatment(6.47 ± 1.55)(P<0.05).Conclusion patients with decompensated hepatitis B cirrhosis with combination of lamivudine and adefovir dipivoxil treatment, the clinical efficacy is more significant, HBeAg seroconversion rate is increased , the score of Child-Pugh become low and improve liver reserve function, reduce HBV-DNA load in serum.