CAJ | 학술논문

目的研究拉米夫定(LAM)联合阿德福韦酯(ADV)治疗失代期乙型肝炎肝硬化的临床疗效.方法 136例失代偿期乙型肝炎肝硬化患者在综合护肝及对症治疗基础上,联合组46例给予拉米夫定100 mg/d和阿德福韦酯10 mg/d口服;LAM组47例给予拉米夫定100 mg/d口服;ADV组43例给予阿德福韦酯10mg/d口服.在治疗前和治疗第6个月、12个月时观察肝功能、肝功能Child-Pugh计分以及HBV-DNA水平的变化.结果治疗第6个月、第12个月时拉米夫定和阿德福韦酯联合组HBV DNA阴转率(＜1×103 cop/ml)分别为78.3%、85.2%,拉米夫定组分别为62.1%、57.8%,阿德福韦酯组分别为41.3%、53.6%;联合治疗组明显优于单用组;肝功能好转率联合治疗组明显优于单用组;肝功能Child-Pugh计分改善率联合治疗组明显优于单用组.结论拉米夫定联合阿德福韦酯抗病毒治疗失代偿期乙型肝炎肝硬化优于单用拉米夫定或阿德福韦酯治疗.
목적 연구랍미부정(LAM)연합아덕복위지(ADV)치료실대기을형간염간경화적림상료효.방법 136례실대상기을형간염간경화환자재종합호간급대증치료기출상,연합조46례급여랍미부정100 mg/d화아덕복위지10 mg/d구복;LAM조47례급여랍미부정100 mg/d구복;ADV조43례급여아덕복위지10mg/d구복.재치료전화치료제6개월、12개월시관찰간공능、간공능Child-Pugh계분이급HBV-DNA수평적변화.결과 치료제6개월、제12개월시랍미부정화아덕복위지연합조HBV DNA음전솔(＜1×103 cop/ml)분별위78.3%、85.2%,랍미부정조분별위62.1%、57.8%,아덕복위지조분별위41.3%、53.6%;연합치료조명현우우단용조;간공능호전솔연합치료조명현우우단용조;간공능Child-Pugh계분개선솔연합치료조명현우우단용조.결론 랍미부정연합아덕복위지항병독치료실대상기을형간염간경화우우단용랍미부정혹아덕복위지치료.
Objective To evaluate the effect of the combination of lamivudine and adefovir dipivoxil on the treatment of decompensated hepatitis B cirrhosis patients. Methods One hundred thirty-six patients with decompensated hepatitis B cirrhosis were randomly administered the combination of lamivudine and adefovir dipivoxil (combination group), only lamivudine( LAM group)and only adefovir dipivoxil (ADV group). The liver founction tests, ChildPugh scores and the rate of negative conversion for the serum HBV-DNA were measured at baseline,six months after therapy and 12 months after therapy. Results The rate of negative conversion for the serum HBV-DNA ( ＜ 1 ×103cop/ml)of combination group were 78.3% and 85.2% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of LAM group were 62. 1% and 57.8% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of ADV group were 41.3% and 53.6% respectively at six and twelve months after therapy. Compared with the LAM and ADV group, The rates of negative conversion for the serum HBV-DNA of combination group were higher. In addition, the rates of better conversion of liver function tests and Child-Pugh scores were higher in combination group than LAM and ADV groups.Conclusion The combination of lamivudine and adefovir dipivoxil could more effectively improve liver founction tests, Child-Pugh scores and the rates of negative conversion for the serum HBV-DNA in patients with decompensated hepatitis B cirrhosis than only lamivudine and only adefovir dipivoxil.