CAJ | 학술논문

目的：探究拉米夫定联合阿德福韦酯治疗HBeAg阳性失代偿期乙肝肝硬化患者的临床疗效。方法回顾性分析2014年1月～2015年1月收治的HBeAg阳性失代偿期乙肝肝硬化患者，共100例，将给予拉米夫定初始治疗耐药后加用阿德福韦酯挽救治疗的50名患者作为对照组，同时选取给予拉米夫定加阿德福韦酯初始联合治疗的患者50例，作为观察组，比较分析2组治疗的临床疗效。结果观察组患者治疗后HBeAg血清学转阴率26.00％显著高于对照组4.00％（ P＜0.05）；观察组患者治疗后12周（9.63±1.42）、24周（8.57±1.45）、48周（7.43±1.57） Child-Pugh分级评分分数显著低于对照组（9.74±1.21）、（9.45±1.33）、（8.57±1.04）（P＜0.05）；观察组患者治疗后血清中HBV-DNA载量（2.23±1.25）显著低于对照组（5.18±1.63），且观察组治疗后（2.23±1.25）血清中HBV-DNA载量显著低于治疗前（6.47±1.55）（P＜0.05）。结论治疗HBeAg阳性失代偿期乙肝肝硬化患者采用初始联合拉米夫定和阿德福韦酯治疗，临床效果显著，HBeAg血清学转阴率高，且Child-Pugh分级评分分数降低，改善肝脏储备功能，血清中HBV-DNA载量降低。
목적：탐구랍미부정연합아덕복위지치료HBeAg양성실대상기을간간경화환자적림상료효。방법회고성분석2014년1월～2015년1월수치적HBeAg양성실대상기을간간경화환자，공100례，장급여랍미부정초시치료내약후가용아덕복위지만구치료적50명환자작위대조조，동시선취급여랍미부정가아덕복위지초시연합치료적환자50례，작위관찰조，비교분석2조치료적림상료효。결과관찰조환자치료후HBeAg혈청학전음솔26.00％현저고우대조조4.00％（ P＜0.05）；관찰조환자치료후12주（9.63±1.42）、24주（8.57±1.45）、48주（7.43±1.57） Child-Pugh분급평분분수현저저우대조조（9.74±1.21）、（9.45±1.33）、（8.57±1.04）（P＜0.05）；관찰조환자치료후혈청중HBV-DNA재량（2.23±1.25）현저저우대조조（5.18±1.63），차관찰조치료후（2.23±1.25）혈청중HBV-DNA재량현저저우치료전（6.47±1.55）（P＜0.05）。결론치료HBeAg양성실대상기을간간경화환자채용초시연합랍미부정화아덕복위지치료，림상효과현저，HBeAg혈청학전음솔고，차Child-Pugh분급평분분수강저，개선간장저비공능，혈청중HBV-DNA재량강저。
Objective To explore the combination of lamivudine and adefovir dipivoxiltreatment in HBeAg positive patients with inappropriate timing of decompensated hepatitis B cirrhosis.Methods Make a retrospective analysis of HBeAg positive patients with decompensated hepatitis B cirrhosis of the liver our hospital in 2014 January ~2015 January were,100 cases of initial treatment, 50 patients given lamivudine plus adefovir dipivoxil resistance as control group,50 cases patients given lamivudine plus adefovir dipivoxil combined as the observation group, compared two groups of clinical curative effect of treatment.Results Observation group after treatment in patients with HBeAgseroconversion rate of 26.00% was significantly higher than that in control group 4.00% (P<0.05);after 12 weeks of treatment in the observation group (9.63 ±1.42), 24 weeks(8.57 ±1.45), 48 weeks(7.43 ±1.57) Child-Pugh grading score was significantly lower than the control group(9.74 ±1.21),(9.45 ±1.33)(8.57 ±1.04)(P <0.05); level of HBV-DNA after treatment in the observation group (2.23 ±1.25) was significantly lower than that of the control group(5.18 ± 1.63), and the Patients in the observation group (2.23 ±1.25)HBV-DNA load in serum was significantly lower than that before treatment(6.47 ± 1.55)(P<0.05).Conclusion patients with decompensated hepatitis B cirrhosis with combination of lamivudine and adefovir dipivoxil treatment, the clinical efficacy is more significant, HBeAg seroconversion rate is increased , the score of Child-Pugh become low and improve liver reserve function, reduce HBV-DNA load in serum.