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目的探讨联合使用阿德福韦酯与拉米夫定在乙型肝炎肝硬化失代偿期病人中抗病毒治疗的安全性与疗效,从而寻找更加有效的治疗方法。方法应用前瞻性随机分组的方法,对64例乙型肝炎肝硬化失代偿期患者随机分成两组。A组予阿德福韦酯(10mg/d)联合拉米夫定(100mg/d)治疗;B组予阿德福韦酯(10mg/d)治疗;直至治疗结束。以上两组的疗程均为48周,分别在治疗的12、24、36和48周抽血,检测各组血清ALT、HBeAg、HBV DNA及child分级变化。结果治疗结束后,两组患者HBV DNA阴转率为87.1%及78.8%,有效率分别为96.8%及87.9%;HBeAg阴转率分别为83.9%及57.6%;HBeAg/抗-HBe血清转换率分别为41.9%及24.2%;血清ALT复常率分别为96.8%及97.0%。结论联合用药可减少耐药的发生,并可增加抗病毒效果,且其安全性良好,但需扩大样本进一步研究。
Objective To investigate the safety and efficacy of antiretroviral therapy combined with adefovir dipivoxil and lamivudine in patients with decompensated hepatitis B in order to find a more effective treatment. Methods Using prospective randomized grouping method, 64 patients with decompensated hepatitis B cirrhosis were randomly divided into two groups. Adefovir dipivoxil (10 mg / d) in combination with lamivudine (100 mg / d) in group A and adefovir dipivoxil (10 mg / d) in group B until the end of treatment. The courses of the above two groups were all 48 weeks. Blood samples were taken at 12, 24, 36 and 48 weeks of treatment respectively. Serum levels of ALT, HBeAg, HBV DNA and child were detected in each group. Results After treatment, the HBV DNA negative conversion rates were 87.1% and 78.8% in both groups, the effective rates were 96.8% and 87.9% respectively; the negative conversion rates of HBeAg were 83.9% and 57.6% respectively; the HBeAg / anti-HBe seroconversion rate Respectively, 41.9% and 24.2% respectively. The rates of abnormal ALT in serum were 96.8% and 97.0% respectively. Conclusions Combination therapy can reduce the occurrence of drug resistance, and can increase the anti-virus effect, and its safety is good, but need to expand the sample for further study.