摘要
目的对比阿德福韦酯与拉米夫定治疗乙型肝炎肝硬化的效果。方法本研究选取2013年4月至2014年4月汝州市第一人民医院感染内科收治的100例乙型肝炎肝硬化患者作为研究对象，随机分为两组，就阿德福韦酯（A组，n=50）与拉米夫定（B组，n=50）的效果进行比较。结果治疗前12周，两组患者除白蛋白外，其他肝功能指标复常率B组均优于A组，但组间差异未见统计学意义（P〉0．05）。两组肝功能复常人数均随疗程延长而增加，至48周，组间对比较差异未见统计学意义（尸〉0．05）。两组治疗前血清HBVDNA水平检测结果差异未见统计学意义（P〉0．05），治疗12周时较疗前明显下降，但差异未见统计学意义（P〉0．05）。B组12周转阴率高于A组，但组间差异未见统计学意义（P〉0．05）。两组HBVDNA水平随疗程延长而降低，但转阴率增加，组间转阴率及HBVDNA水平在各时间点比较差异未见统计学意义（P〉0．05）。治疗48周，A组无病毒变异，B组3例，占6％。两组均无与药物相关的肾功能损害，A组腹胀、乏力、头痛2例，B组腹泻、恶心、消化不良、食欲下降2例，但均可耐受，无因不良反应较严重放弃治疗者。结论肝硬化患者采用阿德福韦酯与拉米夫定均有一致的安全性和疗效，而病毒耐药突变率却低于拉米夫定，故在抗病毒药物中效果较为理想，能够改善预后，最大程度地保障患者的生存质量，故值得临床推广应用。
Objective To compare the effects of adefovir dipivoxil and lamivudine on hepatitis B cirrhosis. Methods One hundred cases of hepatitis B cirrhosis from April 2013 to April 2014 admitted to First People＇s Hospital of Ruzhou were selected and randomly divided into group A （n = 50, received adefovir dipivoxil treatment） and group B （n = 50, received lamivudine therapy）. The effects were com pared. Results Before treatment for 12 weeks, other liver function parameters except for albumin in group B were superior to group A, but the difference was not significant（P 〉 0. 05 ）. Number of normalization of liver function was increased with treatment extended to 48 weeks, there was no significant differ ence（P 〉0.05）. HBV DNA level before treatment between the two groups had no significant difference （P 〉 0.05 ）, and HBV DNA levels at 12 weeks of treatment were significantly lower than those before treatment, and there was also no difference（P 〉0.05）. The negative rate in group B at week 12 was higher than that of group A, but there was no sighificant difference （P 〉 0. 05 ）. The HBV DNA level de- creased with treatment extended but negative rate increased, and the negative rates between the two groups and compare the level of HBV DNA at each time point, there was no significant difference （P 〉 0. 05）. At 48 weeks of treatment, group A had no viral mutation, three cases occurred in group B, ac- counting for 6%. There were no drug-related renal dysfunction, and two cases of bloating, fatigue, head- ache occurred in group A, and two cases of diarrhea, nausea, indigestion, loss of appetite occurred in group B; however, all the cases can be tolerated, and no cases gave up treatment due to serious adverse reactions. Conclusions Cirrhotic patients with adefovir dipivoxil treatment with lamivudine are safe and effective, and the rate is lower than the virus lamivudine resistance mutations. So it can improve the quality of life in patients, so it is worthy in clinical application.
出处
《中国实用医刊》
2015年第9期60-61,共2页
Chinese Journal of Practical Medicine
