摘要
目的:考察阿德福韦酯(ADV)联合拉米夫定(LAM)治疗乙型肝炎肝硬化失代偿期的临床疗效和安全性。方法:回顾性收集156例乙型肝炎肝硬化失代偿期患者的临床资料,ADV组、LAM组和联合组各52例。各组患者均给予静脉输入高渗葡萄糖液、维生素C、胰岛素、氯化钾等常规治疗。在此基础上,LAM组患者给予LAM 50 mg,口服,bid;ADV组患者给予ADV胶囊10mg,口服,bid;联合组患者给予LAM+ADV(用法用量同LAM组、ADV组)。各组患者疗程均为60周。观察各组患者治疗前后丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)、肝脏储备功能量化评分(Child-Pugh),不同时期脱氧核糖核酸(HBV-DNA)阴转率,临床疗效及不良反应发生情况。结果:治疗前各组患者ALT、ALB、TBIL、Child-Pugh评分比较,差异均无统计学意义(P>0.05);治疗后各组患者ALT、TBIL、Child-Pugh评分均显著低于同组治疗前,ALB显著高于同组治疗前,差异有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05)。ADV组和LAM组患者不同时期HBV-DNA阴转率比较,差异均无统计学意义(P>0.05),而联合组患者不同时期HBV-DNA阴转率均显著高于ADV组和LAM组,差异有统计学意义(P<0.05)。联合组患者总有效率显著高于ADV组和LAM组,差异有统计学意义(P<0.05)。各组患者治疗期间均未见与药物相关的严重不良反应发生。结论:ADV联合LAM治疗乙型肝炎肝硬化失代偿期较单用ADV或LAM疗效更好,HBV-DNA阴转率更高,且安全性相当。
OBJECTIVE： To investigate clinical efficacy and safety of adefovir dipivoxil combined with lamivudine in the treat- ment ofdecompensated hepatitis B cirrhosis. METHODS： 156 patients with decompensated hepatitis B cirrhosis were divided into adefovir dipivoxil group （ADV group）, lamivudine group （LAM group） and drug combination group. 3 groups were given Hyper- tonic glucose solution,vitamin C, insulin, potassium chloride and so on as routine treatment. Based on above therapy, LAM group was additionally given LAM 50 mg orally twice a day; ADV group given ADV 10 mg orally twice a day; drug combination group given ADV＋LAM. Treatment course of 3 groups lasted for 60 weeks. The ALT, ALB, TBIL, Child-Pugh and HBV-DNA negative conversion rate were observed in 3 groups before and after treatment. RESULTS： Before treatment, ALT, ALB, TBIL and Child-Pugh score of 3 groups had no statistically significant difference （P〉0.05）. After treatment, ALT, TBIL and Child-Pugh score of 3 groups were significantly lower than before, while ALB were significantly higher than before, and there was statistically significant difference （P〈0.05） ; there was no statistically significant difference among 3 groups（P〉0.05）. HBV-DNA negative conversion rate of ADV group and LAM group at different time points had no statistical significance（P〉0.05）; that of drug combi- nation group was significantly higher than ADV group and LAM group（P〈0.05）, and there was statistically significant difference （P〈0.05）. Total effective rate of drug combination group was significantly higher than those of ADV group and LAM group; there was statistically significant difference（P〈0.05）. No drug-related severe ADR was found in 3 groups during treatment. CONCLU- SIONS： Adefovir dipivoxil combined with lamivudine is more effective than adefovir dipivoxil or lamivudine alone in the treatment of decompensated hepatitis B cirrhosis, and has higher HBV-DNA negative conversion rate and similar safety.
出处
《中国药房》
CAS
北大核心
2015年第6期745-747,共3页
China Pharmacy
关键词
肝硬化失代偿期
阿德福韦酯
拉米夫定
联合治疗
疗效
Decompensated hepatitis B cirrhosis
Adefovir dipivoxil
Lamivudine
Combined treatment
Therapeutic efficacy
