拉米夫定与阿德福韦酯联合治疗乙型肝炎肝硬化疗效观察

摘要

目的 探讨拉米夫定与阿德福韦酯联合治疗乙型肝炎肝硬化的临床疗效和安全性.方法 乙型肝炎肝硬化患者69例,其中初治43例为初治组,对拉米夫定耐药26例为耐药组.初治组予拉米夫定100 mg/d与阿德福韦酯10 mg/d 同服;耐药组在服用拉米夫定的基础上,加用阿德福韦酯10 mg/d.监测治疗前、治疗后3、6、12个月的肝功能、HBV-DNA水平和Child-Pugh分级的变化.结果 2组患者经拉米夫定与阿德福韦酯联合治疗后,HBV-DNA被抑制,在治疗12个月时均下降了2 log拷贝/ml,ALT、AST、TBIL均明显下降.ALB升高,Child-Push计分降低,分级改善;并且随着疗程延长,疗效提高.初治组疗效优于耐药组.结论 拉米夫定与阿德福韦酯联合治疗乙型肝炎肝硬化可在病毒学及生物化学方面得到较好疗效,且安全性良好.%Objective To investigate the clinical effect of Combined Lamivudine and Adefovir for hepatitis B and cirrhosis.nethotis Sixty-nine patients of hepatitis B and cirrhosis were enrolled.including 43 initial treatment cases and 6 Lamivudine-resistant cases.The initially treated patients took Lamivudine 100 mg/d and Adefovir 10 mg/d simultaneously.Meanwhile the Lamivudine.resistant patients took lamivudine before taking Adefovir 10 mg/d.Liver function Was monitored,and the HBV-DNA's level and the Child-Pugh grade's change 3、6、1 months before and after therapy.Results The HBV-DNA decreased log copy/ml 1 months after treatment.ALT,AST,TBIL dropped down significantly after the combined use of Lamivudine and Adefovir.ALB rised and Child-Pugh scores reduced.Conciusion The combined use of Lamivudine and Adefovir is safe and effeetive for hepatitis B and cirrhosis.