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目的观察阿德福韦酯治疗失代偿期乙型肝炎肝硬化的临床疗效。方法 58例失代偿期乙型肝炎肝硬化患者,随机分为对照组和治疗组,其中对照组予以拉米夫定治疗,治疗组应用阿德福韦酯治疗,比较两组患者的临床症状体征改善情况,治疗前后肝功能变化情况,治疗后血清HBV DNA转阴率比较,以及不良反应情况。结果治疗组临床症状体征明显改善,明显优于对照组(P<0.05);与对照组相比,治疗组TBiL、ALT、AST明显改善降低(P<0.05);而与本组治疗前组比,两组TBiL、ALT、AST均有不同程度的降低,其中治疗组下降幅度尤为明显(P<0.05);两组治疗后血清HBV DNA转阴率均有一定改善,与对照组相比,治疗组于治疗结束后后9~12个月复查血清HBV DNA,其转阴率明显改善(P<0.05);治疗组不良反应低于对照组。结论采用阿德福韦酯对失代偿期乙型肝炎肝硬化的治疗效果优于拉米夫定治疗。
Objective To observe the clinical efficacy of adefovir dipivoxil in the treatment of decompensated hepatitis B cirrhosis. Methods 58 patients with decompensated hepatitis B cirrhosis were randomly divided into control group and treatment group, in which the control group was lamivudine treatment, the treatment group was treated with adefovir dipivoxil, and the clinical symptoms of the two groups were compared Signs of improvement, changes in liver function before and after treatment, serum HBV DNA after treatment, the rate of negative conversion, and adverse reactions. Results Compared with the control group, the clinical symptoms and signs in the treatment group were significantly improved (P <0.05). Compared with the control group, the TBiL, ALT and AST in the treatment group were significantly decreased (P <0.05) , The TBiL, ALT and AST in both groups decreased to some extent, especially in the treatment group (P <0.05). After treatment, the serum HBV DNA negative conversion rate was improved in both groups. Compared with the control group, Serum HBV DNA was reexamined 9 to 12 months after the end of treatment, and the negative conversion rate was significantly improved (P <0.05). The adverse reactions in the treatment group were lower than those in the control group. Conclusion The treatment effect of adefovir dipivoxil on decompensated hepatitis B cirrhosis is better than that of lamivudine.