目的 观察拉米夫定与阿德福韦酯联合治疗乙型肝炎肝硬化代偿期的临床疗效、安全性及耐药率.方法 治疗组23例患者给予拉米夫定与阿德福韦酯联合治疗,对照组21例患者单用拉米夫定,观察96周.结论 治疗组在血生化指标改善优于对照组(P＜0.05),治疗组与对照组比较HBV DNA阴转率48周时(82.61%、66.67%)、96周时(95.65%、61.90%),HBeAg阴转率48周时(30.43%、4.76%)、96周时(43.48%、14.29%),HBeAg转换率48周时(8.70%,0%)、96周时(13.04%、4.76%),均差异有显著性(P＜0.05).治疗组96周耐药率为0%,而对照组48周和96周耐药率分别为4.76%和33.33%.结论拉米夫定与阿德福韦酯联合治疗活动期乙型肝炎肝硬化代偿期,可快速抑制病毒复制,改善肝功能,延缓耐药发生.%Objective To evaluate the efficacy , safety and ressistance ratio of combination therapy of lamivudine (LAM) and adefovir dipivoxyl (ADV)for patients with hepatitis B-induced compensated cirrhosis. Methods The combination group (re = 23) were treated with LAM (100 mg?d-1)plus ADV (10 mg?d-1),and the control group(re =21)with LAM (100 mg?d-1)for 96 weeks. Results The blood biochemical improvement in combination group was superior to control group (P <0. 05). The HBV-DNA undetectable rates were obviously higher in combination group than in control group both at 48 th weekend ( 82. 61 % vs 66. 67 % , P < 0. 05 ) and 96 th weekend (95. 65% vs 61. 90% ,P <0.05 ). The negative rate of hepatitis B e antigen ( HBeAg) between combination group and control group was significantly different not only at 48 th weekend(30.43% vs 4.76% ,P <0. 05) but also at 96th weekend (43. 48 vs 14. 29% ,P < 0.05 ). The seroconversion rate HBeAg showed us similar results at 48th weekend ( 8.70% vs 0% ,P < 0.05 ) , as well as at 96th weekend (13.04% vs 4.76% ,P <0.05 ). No drug resistance occurred in combination group for 96 weeks,but the drug resistance rate was 4.76% and 33. 33% respectively at 48th and 96th weekend of control group. Conclusion The combination therapy of LAM and ADV for patients with hepatitis B-induced compensated cirrhosis can inhibit viral replication , improve liver function quickly ,and delay drug resistance.
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