拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效观察

武玲; 武德廉

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效观察

武玲 , 武德廉

文章导航 > 蚌埠医学院学报 > 2012, 36 > 2: (186-188)

引用本文:

Citation:

拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效观察

武玲,
武德廉

1.
安徽省宿州市立医院感染科,234000

作者简介: 武玲(1974-)，女，主治医师

基金项目:

The curative effects of lamivudine and adefovir dipivoxil combined antiviral treatment on decompensated period hepatitis B liver cirrhosis

WU Ling,
WU De-lian

1.
Department of Infection, Suzhou Municipal Hospital, Suzhou Anhui 234000, China

摘要: 目的：观察拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效。方法：将68例失代偿期乙型肝炎肝硬化患者随机分为3组，在保肝治疗的基础上，A组给予拉米夫定(100 mg/d)、阿德福韦酯(10 mg/d)，B组给予拉米夫定(100 mg/d)，C组给予阿德福韦酯(10 mg/d)，治疗为48周。观察所有患者丙氨酸氨基转移酶复常率，HBeAg/HBeAb血清转换率、HBVDNA阴转率以及Child-Pugh评分。结果：通过抗病毒治疗，3组无一例死亡。随治疗时间的延长，A组患者ALT复常率逐渐增高，且与B组和C组相比，治疗48周末ALT复常率明显增高(P；0.05)。Child-Pugh评分有明显改善(P；0.01)。A、B、C组HBeAg/HBeAb血清学转换率分别为20.8%、13.6%、9.1%，A组与B、C组比较差异无统计学意义(P；0.05)；A、B、C组HBeAg阴转率分别为62.5%、31.8%、27.3%，A组与B、C组比较差异有统计学意义(P；0.05)。结论：失代偿期乙型肝炎肝硬化患者使用拉米夫定联合阿德福韦酯抗病毒治疗能快速抑制HBV DNA的复制，有效提高丙氨酸氨基转移酶的复常率，改善肝功能，延缓病情发展，实现肝硬化治疗的目标。
- 乙型肝炎 /
- 失代偿肝硬化 /
- 拉米夫定 /
- 阿德福韦酯 /
- 联合
Abstract: Objective:To observe the effects of nucleoside drugs combination therapy against decompensated period Hepatitis B liver cirrhosis. Methods:Sixty-eight cases with decompensated period Hepatitis B liver cirrhosis were divided into three groups randomly:based on the routine therapy,patients in A group were treated with lamivudine 100 mg/d and adefovir dipivoxil 10 mg/d;patients in B group were treated with lamivudine 100 mg/d,and with adefovir dipivoxil 10 mg/d in C group.After treatment for 48 weeks,the ALT recovery rate,HBeAg/anti-HBe sero-conversion rate,HBV DNA negative rate,and Child-pugh score were observed. Results:Through the antiviral treatment in these three groups,no death was happened.The ALT recovery rate in A group had a certain degree improvement with time,and in contrast to B and C group,the ALT recovery rate was increased significantly after 48 weeks treatment.The Child-pugh scores in all group had improved remarkably.HBeAg/anti-HBe sero-conversion rate in A,B,and C group was 20.83%,13.63% and 9.1%,respectively,there had no statistical differences among the three groups(P0.05).HBeAg negative rate in A,B,and C group was 62.5%,27.3% and 22.7%,in contrast to A group,there had significant differences about HBeAg negative rate in B and C group(P0.05). Conclusions:Lamivudine and adefovir dipivoxil combined antiviral treatment for decompensated period Hepatitis B liver cirrhosis can rapidly control the copy of HBV DNA,improve liver function effectively,delay the progress of disease,and finally achieve the treatment goal against liver cirrhosis.
- hepatitis B /
- decompensated cirrhosis /
- lamivudine /
- adefovir /
- combination

[1]	中华医学会肝病学分会和感染病学分会.慢性乙型肝炎防治指南[J].实用肝脏病杂志,2006,9(1):8-18.
[2] 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华传染病杂志,2001,19(1):56-62.
[3] 谢青,桂红莲.乙型肝炎病毒相关肝硬化的抗病毒治疗[J].中华肝脏病杂志,2006.14(11):837-838.
[4] 于乐成,张欣欣,陈成伟,等.美国慢性乙型肝炎病毒感染处理流程详细介绍[J].肝脏,2006,11(6):418-432.
[5] 姚光弼,崔振宇,姚集鲁,等.国产拉米夫定治疗2200例慢性乙型肝炎的Ⅵ期临床试验[J].中华肝脏病杂志,2003,11(2):103-108.
[6] 杜以真,王磊,刘峰,等.拉米夫定治疗乙型肝炎失代偿期肝硬化长期疗效观察[J].肝脏,2006,11(5):318-321.
[7] Marcellin P.Advance in therapy for chronic hepatitis B[J].Semin Liver Dis,2002,22(suppl):33-36.
[8] 张雅敏,朱志军,郑虹,等.阿德福韦在预防肝移植后乙肝复发中的作用[J].中华肝胆外科杂志,2006,12(5):313-315.

[1]	周怀德 . 拉米呋啶和阿德福韦酯治疗慢性乙型肝炎疗效观察. 蚌埠医学院学报, 2010, 35(3): 277-278.
[2]	顾征太 . 虎踞乙肝胶囊联合阿德福韦酯抗慢性乙肝肝纤维化的疗效观察. 蚌埠医学院学报, 2017, 42(3): 359-361. doi: 10.13898/j.cnki.issn.1000-2200.2017.03.023
[3]	张礼周 , 张振华 , 梁佳佳 , 方立庆 , 李旭 . 阿德福韦酯治疗慢性乙型肝炎原发性无应答患者基因型耐药分析. 蚌埠医学院学报, 2014, 38(2): 182-183.
[4]	范凌 . 替比夫定与拉米夫定治疗慢性乙型肝炎疗效观察. 蚌埠医学院学报, 2017, 42(1): 73-75. doi: 10.13898/j.cnki.issn.1000-2200.2017.01.020
[5]	尚莉莉 . 阿德福韦酯治疗慢性乙型肝炎疗效观察. 蚌埠医学院学报, 2010, 35(1): 54-55.
[6]	张志敏 , 季宝玉 , 李琳 . 恩替卡韦联合a-2b干扰素治疗慢性乙型肝炎的疗效观察. 蚌埠医学院学报, 2014, 38(5): 621-622.
[7]	张磊 , 刘传苗 . 恩替卡韦或替诺福韦治疗慢性乙型肝炎病毒感染干扰素-λ3的水平研究. 蚌埠医学院学报, 2021, 46(6): 743-747. doi: 10.13898/j.cnki.issn.1000-2200.2021.06.010
[8]	张加功 . 苦参素联合猪苓多糖治疗慢性乙型肝炎临床分析. 蚌埠医学院学报, 2006, 31(2): 169-170.
[9]	徐瑞芳 , 张志锋 , 张曹庚 , 殷秋炯 , 刘红 . 恩替卡韦治疗慢性乙型肝炎53例疗效分析. 蚌埠医学院学报, 2014, 38(1): 75-77.
[10]	崔甫朦 , 赵守松 . HBsAg < 1 500 IU/mL的慢性乙型肝炎病人联合聚乙二醇干扰素α-2b治疗的疗效观察. 蚌埠医学院学报, 2021, 46(6): 735-739. doi: 10.13898/j.cnki.issn.1000-2200.2021.06.008
[11]	盛仅翠 . 小剂量肝素钠联合低分子右旋糖酐治疗慢性乙型肝炎效果观察. 蚌埠医学院学报, 2008, 33(2): 198-199.
[12]	吴取梅 , 赵久法 . 恩替卡韦治疗慢性乙型肝炎病毒感染的疗效观察及其影响因素. 蚌埠医学院学报, 2017, 42(12): 1604-1608. doi: 10.13898/j.cnki.issn.1000-2200.2017.12.010
[13]	易婉婉 , 孙奋勇 . 慢性乙型肝炎外周血T淋巴细胞亚群变化的Meta分析. 蚌埠医学院学报, 2016, 41(4): 438-444. doi: 10.13898/j.cnki.issn.1000-2200.2016.04.005
[14]	张红云 , 徐瑞芳 , 田怡 , 张志峰 , 刘红 , 张曹庚 , 邓文宗 , 刘雨 , 施燕芬 , 刘海玲 , 孙秀娟 . 乙型肝炎大蛋白在慢性乙型肝炎抗病毒疗效评估中的意义. 蚌埠医学院学报, 2016, 41(4): 479-481. doi: 10.13898/j.cnki.issn.1000-2200.2016.04.017
[15]	高慧婕 , 刘超 , 李倩 . 乙型肝炎患者睾丸和附睾组织HBV DNA检测. 蚌埠医学院学报, 2008, 33(2): 150-152,254.
[16]	范新星 , 崔甫朦 , 王福生 , 赵守松 . NAs治疗慢性乙型肝炎后HBsAg变化的特点和影响因素分析. 蚌埠医学院学报, 2019, 44(5): 582-584, 589. doi: 10.13898/j.cnki.issn.1000-2200.2019.05.005
[17]	李霞 , 廖自文 , 张伟丽 , 刘增义 , 牛多芳 . 1562例六项乙型肝炎血清标志物的检测及结果分析. 蚌埠医学院学报, 2004, 29(5): 469-471.
[18]	刘培明 . 乙型肝炎病毒感染患者前S1蛋白、HBV-M检测结果的比较. 蚌埠医学院学报, 2006, 31(2): 188-189.
[19]	伍宏兵 , 王金萍 , 许红强 , 陈晓艺 , 常丽娜 , 李保启 . 声触诊组织定量技术对慢性乙型肝炎肝纤维化程度的诊断价值. 蚌埠医学院学报, 2014, 38(5): 643-645.
[20]	昝丽娜 , 石秀芳 , 孙峰 . 皖北地区乙型肝炎患者HBV血清标志物与HBV-DNA定量检测的比较. 蚌埠医学院学报, 2013, 37(3): 343-345.

点击查看大图

计量

文章访问数: 2900
HTML全文浏览量: 336
PDF下载量: 120
被引次数: 0

拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效观察

武玲
武德廉

作者简介: 武玲(1974-)，女，主治医师

1. 安徽省宿州市立医院感染科,234000

收稿日期: 2011-05-12
网络出版日期: 2012-02-15

基金项目:

关键词:

摘要: 目的：观察拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化的疗效。方法：将68例失代偿期乙型肝炎肝硬化患者随机分为3组，在保肝治疗的基础上，A组给予拉米夫定(100 mg/d)、阿德福韦酯(10 mg/d)，B组给予拉米夫定(100 mg/d)，C组给予阿德福韦酯(10 mg/d)，治疗为48周。观察所有患者丙氨酸氨基转移酶复常率，HBeAg/HBeAb血清转换率、HBVDNA阴转率以及Child-Pugh评分。结果：通过抗病毒治疗，3组无一例死亡。随治疗时间的延长，A组患者ALT复常率逐渐增高，且与B组和C组相比，治疗48周末ALT复常率明显增高(P；0.05)。Child-Pugh评分有明显改善(P；0.01)。A、B、C组HBeAg/HBeAb血清学转换率分别为20.8%、13.6%、9.1%，A组与B、C组比较差异无统计学意义(P；0.05)；A、B、C组HBeAg阴转率分别为62.5%、31.8%、27.3%，A组与B、C组比较差异有统计学意义(P；0.05)。结论：失代偿期乙型肝炎肝硬化患者使用拉米夫定联合阿德福韦酯抗病毒治疗能快速抑制HBV DNA的复制，有效提高丙氨酸氨基转移酶的复常率，改善肝功能，延缓病情发展，实现肝硬化治疗的目标。

English Abstract

The curative effects of lamivudine and adefovir dipivoxil combined antiviral treatment on decompensated period hepatitis B liver cirrhosis

WU Ling
WU De-lian

1. Department of Infection, Suzhou Municipal Hospital, Suzhou Anhui 234000, China

Received Date: 2011-05-12
Available Online: 2012-02-15

Abstract: Objective:To observe the effects of nucleoside drugs combination therapy against decompensated period Hepatitis B liver cirrhosis. Methods:Sixty-eight cases with decompensated period Hepatitis B liver cirrhosis were divided into three groups randomly:based on the routine therapy,patients in A group were treated with lamivudine 100 mg/d and adefovir dipivoxil 10 mg/d;patients in B group were treated with lamivudine 100 mg/d,and with adefovir dipivoxil 10 mg/d in C group.After treatment for 48 weeks,the ALT recovery rate,HBeAg/anti-HBe sero-conversion rate,HBV DNA negative rate,and Child-pugh score were observed. Results:Through the antiviral treatment in these three groups,no death was happened.The ALT recovery rate in A group had a certain degree improvement with time,and in contrast to B and C group,the ALT recovery rate was increased significantly after 48 weeks treatment.The Child-pugh scores in all group had improved remarkably.HBeAg/anti-HBe sero-conversion rate in A,B,and C group was 20.83%,13.63% and 9.1%,respectively,there had no statistical differences among the three groups(P0.05).HBeAg negative rate in A,B,and C group was 62.5%,27.3% and 22.7%,in contrast to A group,there had significant differences about HBeAg negative rate in B and C group(P0.05). Conclusions:Lamivudine and adefovir dipivoxil combined antiviral treatment for decompensated period Hepatitis B liver cirrhosis can rapidly control the copy of HBV DNA,improve liver function effectively,delay the progress of disease,and finally achieve the treatment goal against liver cirrhosis.