摘要
目的观察拉米夫定联合阿德福韦酯片治疗失代偿期乙型肝炎肝硬化患者的临床疗效,为临床诊治提供参考。方法回顾性分析2006年5月-2010年12月采用拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者临床资料,将234例失代偿乙型肝炎肝硬化患者分为治疗组96例和对照组138例,治疗组常规保肝、对症治疗外,给予拉米夫定100mg和阿德福韦酯10mg,每日口服1次,直至患者随访结束,对照组按常规给予保肝及对症处理;比较两组在住院次数、自发性腹膜炎、肝性脑病、上消化道出血、原发性肝细胞癌的发生率、生存率及Child-pugh评分方面的变化,统计分析采用t检验和χ2检验。结果两组在年住院次数、自发性腹膜炎、肝性脑病、上消化道出血、原发性肝细胞癌发生率、生存率方面差异均有统计学意义(P<0.01);抗病毒治疗组中child-pugh B级病例转为A级病例37例,转化率为56.1%,C级病例转为B级病例10例,转化率为33.3%;非抗病毒组child-pughB级病例转为A级病例18例,转化率为20.2%,C级病例转为B级病例为8例,转化率16.3%。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患者临床疗效显著,能提高生存质量,延长生命时间。
OBJECTIVE To observe the clinical efficacy of lamivudine combined with adefovir dipivoxil in treatment of decompensated hepatitis B cirrhosis. METHODS The clinical data of 234 cases of decompensated hepatitis B cir- rhosis who were treated with lamivudine combined with adefovir dipivoxil from May 2006 to Dec 2010 were retro- spectively analyzed, then the subjects were divided into the treatment group with 96 cases and the control group with 138 cases; the treatment group was treated with 100mg of lamivudine and 10 mg of adefovir based on the rou- tine liver protection treatment and symptomatic Ireatment, oral administration per day, till the end of follow-up; while the control group was given the routine liver protection therapy and symptomatic treatment; the frequency of hospitalization, the incidence of spontaneous bacterial peritonitis, hepatic encephalopathy, upper gastrointestinal hemorrhage, or hepatocellular carcinoma, the survival rate, and child-pugh score were observed and compared be- tween the two groups; the t-test and the chi square test were performed for the statistical analysis. RESULTS The difference in the frequency of hospitalization, incidence of spontaneous bacterial peritonitis, incidence of hepatic encephalopathy, incidence of upper gastrointestinal hemorrhage, incidence of hepatocellular carcinoma, or survival rate between the two groups was statistically significant（P〈0.01）. In the antiviral group, there were 37 （56.10%）cases of child-pugh B who converted to child-pugh B and 10 （33.3 % ） cases of child-pugh C who converted to B; in the non-antiviral group, there were 18 （20.2%） cases of child-pugh B who converted to A and 8 （16.3%） cases of child-pugh C who converted to B. CONCLUSION Lamivudine combined with adefovir can achieve significant clinical efficacy in treatment of decompensated hepatitis B cirrhosis, improve the quality of life, and prolong the survival time.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第2期361-363,共3页
Chinese Journal of Nosocomiology
基金
安阳市重大科技基金项目(2008-15)
