两种核苷(酸)类似物治疗慢乙肝失代偿期肝硬化对比研究

孙屹峰; 秦咏梅; 杨道坤

两种核苷(酸)类似物治疗慢乙肝失代偿期肝硬化对比研究

新乡医学院第一附属医院

详细信息

中图分类号: R575.2;R512.62
计量
- 文章访问数: 2067
- HTML全文浏览量: 15
- PDF下载量: 714
- 被引次数: 0
出版历程
- 出版日期: 2009-04-20

摘要

摘要: 目的观察比较肝炎肝硬化失代偿期患者应用拉米夫定、阿德福韦酯抗病毒治疗的疗效和安全性。方法伴有HBV复制的失代偿肝硬化患者86例,随机分为3组,A组29例,拉米夫定100mg/d,B组31例,阿德福韦酯10mg/d,C组26例为对照。治疗12周、48周、96周分别进行疗效评价。结果治疗前、治疗24周、48周、96周,Child-Pugh评分分别为:A组8.6±1.1,6.3±0.6,6.6±0.8,6.3±0.7;B组8.8±0.7,6.4±0.9,6.1±0.9,6.1±0.7;C组9.0±1.1,8.5±1.1,9.1±1.1,9.0±1.0;血清HBV DNA阴转率分别为A组0,96.6%（28/29）,93.1%（27/29）,89.7%（26/29）;B组0,67.7%（21/31）,93.5%（29/31）,100%（31/31）。C组0,3.8%（1/26）,3.8%（1/26）,0。结论拉米夫定、阿德福韦酯治疗HBV所致失代偿期肝硬化,可抑制病毒复制,改善肝功能,降低Child-Pugh评分,长期服用安全、耐受性好,两者之间疗效无差异。
- 肝炎肝硬化 /
- 核苷类似物 /
- 拉米夫定 /
- 阿德福韦酯
Abstract: Objective The aim of the research was to evaluate the therapy efficacy and safety of Lamivudine and adefovir on the treatment of decompensated cirrhosis due to chronic hepatiti B.Methods 86 patients with decompensated cirrhosis of hepatitis B virus (HBV) infection (Child-Pugh class B) were divided into three groups randomly.29 patients of group A were given Lamivudine 100mg/d, 31 patients of group B were given Adefovir 10mg/d, 26 patients of group C were control group.Results After the treatment of 12 to 24 weeks, Both the patients of group A and group B had a very well therapeutic effect.The Child-Pugh scores of group A was 8.6±1.1 at the pretreatment, 6.3±0.6, 6.6±0.8, 6.3±0.7 at weeks 24, 48, 96, respectively;That of group B was 8.8±0.7, 6.4±0.9, 6.1±0.9, 6.1±0.7 respectively;The Child-Pugh scores of group C was 9.0±1.1, 8.5±1.1, 9.1±1.1, 9.0±1.0 respectively.The negative rate of HBV DNA in group A were 0 at the pretreatment, 96.6% (28/29) , 93.1% (27/29) , 89.7% (26/29) , at weeks 24, 48, 96, respectively;in the group B is 0, 67.7% (21/31) , 93.5% (29/31) , 100% (31/31) , respectively, in the group c is 0, 3.8% (1/26) , 3.8% (1/26) , 0, respectively.Conclusion Lamivudine and adefovir can inhibit HBV replication in decompensated cirrhosis patients due to hepatitis B, resulting in an improvement in liver function, and decrease in Child-Pugh score, It is safe and well tolerated for long term treatment in those patients.There is no difference of therapeutic effect in these two kind of medcine.
- hepatic cirrhosis /
- nucleoside analog /
- Lamivudine /
- Adefovir

HTML全文

参考文献(7)

[1]魏来.拉米夫定治疗乙型肝炎肝硬化的研究进展[J].中华肝脏病杂志, 2005, 13 (1) :77-78.

[2] 中华医学会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) ∶324-329.

[3]张月荣, 张月萍, 张涛.失代偿肝硬化抗病毒治疗的临床价值[J].临床肝胆病杂志, 2006, 22 (2) ∶111-112.

[4]初玉琳.拉米夫定治疗失代偿性乙型肝炎肝硬化60例[J].肝脏, 2006, 11 (2) ∶115-116.

[5]Nagasaki F, Ueno Y, Yamamoto T, et al.Sustained clinical im-provement of a patient with decompensated hepatitis B virus-relat-ed cirrhosis after treatment with lamivudine monotherapy[J].To-hoku J Exp Med, 2006, 210 (1) ∶29-36.

[6]Kim KM, Choi WB, Lim YS, et al.Adefovir dipivoxil alone or incombination with ongoing lamivudine in patients with decompensatedliver disease and lamivudine-resistant hepatitis B virus[J].Ko-rean Med Sci, 2005, 20 (5) ∶821-828.

[7]Moon W, Choi MS, Moon YM, et al.Efficacy and safety of adefo-vir dipivoxil in patients with decompensated liver cirrhosis withLamivudine resistance compared to patients with compensated liverdisease[J].Korean J Hepatol, 2005, 11 (2) ∶125-134.

施引文献

资源附件(0)

访问统计