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目的观察恩替卡韦等核苷类似物在乙型肝炎肝硬化失代偿期患者中抗病毒治疗的安全性与疗效。方法69例乙型肝炎肝硬化失代偿期患者随机分成2组,分别给予恩替卡韦、拉米夫定联合阿德福韦酯两种方案,观察所有病例症状、体征、生化学指标、HBV DNA阴转、HBeAg阴转、抗-HBe阳转以及Child-Pugh评分分级变化等情况。结果两组患者无一例死亡,临床症状、体征、肝功能均有明显改善,HBeAg血清转换率分别为42.1%、41.9%,差异无统计学意义(P>0.05),HBV DNA阴转率两组分别为92.1%、84.1%,组间比较差异无统计学意义(P>0.05)。结论乙型肝炎肝硬化失代偿期患者选用恩替卡韦或拉米夫定联合阿德福韦酯安全性及疗效无显著差异。
Objective To observe the safety and efficacy of antiviral drugs such as entecavir and other nucleoside analogues in patients with decompensated hepatitis B cirrhosis. Methods Sixty-nine patients with decompensated hepatitis B cirrhosis were randomly divided into 2 groups: entecavir, lamivudine and adefovir dipivoxil respectively. The symptoms, signs, biochemical indexes, HBV DNA Turn, HBeAg negative, anti-HBe positive and Child-Pugh score grading changes and so on. Results There was no death, clinical symptoms, signs and liver function in both groups. The HBeAg seroconversion rates were 42.1% and 41.9% respectively, with no significant difference (P> 0.05) Respectively, 92.1%, 84.1%, there was no significant difference between the two groups (P> 0.05). Conclusion The safety and efficacy of entecavir or lamivudine in combination with adefovir dipivoxil in patients with decompensated hepatitis B are not significantly different.