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目的:观察替比夫定联合阿德福韦酯长期治疗活动性乙型肝炎肝硬化的疗效及安全性。方法:76例活动性乙型肝炎肝硬化患者,按随机数字表法分为观察组和对照组,各38例。对照组患者给予阿德福韦酯10 mg,qd;观察组患者在对照组基础上加用替比夫定600 mg,qd。两组患者均连续服用2年。观察两组患者治疗后血清胆红素(TBIL)、白蛋白(ALB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、乙型肝炎病毒的脱氧核糖核酸(HBV-DNA)转阴率、血清病毒学指标,并比较两组患者的临床疗效及不良反应。结果:治疗后,观察组患者的AST、ALB、ALT、TBIL水平均显著优于对照组,两组比较差异有统计学意义(P<0.05);观察组患者治疗后1、2年HBV-DNA病毒转阴率、血清病毒下降幅度均显著高于对照组,两组比较差异有统计学意义(P<0.05);观察组患者的临床总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05);两组患者均未见明显不良反应发生。结论:替比夫定联合阿德福韦酯可以显著地改善乙型肝炎肝硬化患者肝功能水平,长期疗效良好,且安全性高。
Objective: To observe the long-term efficacy and safety of telbivudine combined with adefovir dipivoxil in the treatment of active hepatitis B cirrhosis. Methods: Seventy-six patients with active hepatitis B cirrhosis were randomly divided into observation group and control group according to the random number table method, with 38 cases in each group. Control group patients were given adefovir dipivoxil 10 mg, qd; observation group patients on the basis of the control group plus telbivudine 600 mg, qd. Two groups of patients were taken continuously for 2 years. Serum bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatitis B virus DNA- Negative rate, serum virological indicators, and compared the clinical efficacy and adverse reactions in both groups. Results: After treatment, the levels of AST, ALB, ALT and TBIL in the observation group were significantly better than those in the control group, with significant difference between the two groups (P <0.05); HBV- DNA in the observation group one and two years after treatment The negative rate of virus and the rate of decrease of serum virus were significantly higher than those of the control group (P <0.05). The total effective rate of the observation group was significantly higher than that of the control group Significance (P <0.05); no obvious adverse reactions occurred in both groups. Conclusion: Telbivudine combined with adefovir dipivoxil can significantly improve the liver function of patients with hepatitis B cirrhosis, long-term effect is good and safe.