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目的观察拉米夫定联合阿德福韦酯片治疗失代偿期乙型肝炎肝硬化患者的临床疗效,为临床诊治提供参考。方法回顾性分析2006年5月-2010年12月采用拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者临床资料,将234例失代偿乙型肝炎肝硬化患者分为治疗组96例和对照组138例,治疗组常规保肝、对症治疗外,给予拉米夫定100mg和阿德福韦酯10mg,每日口服1次,直至患者随访结束,对照组按常规给予保肝及对症处理;比较两组在住院次数、自发性腹膜炎、肝性脑病、上消化道出血、原发性肝细胞癌的发生率、生存率及Child-pugh评分方面的变化,统计分析采用t检验和χ2检验。结果两组在年住院次数、自发性腹膜炎、肝性脑病、上消化道出血、原发性肝细胞癌发生率、生存率方面差异均有统计学意义(P<0.01);抗病毒治疗组中child-pugh B级病例转为A级病例37例,转化率为56.1%,C级病例转为B级病例10例,转化率为33.3%;非抗病毒组child-pughB级病例转为A级病例18例,转化率为20.2%,C级病例转为B级病例为8例,转化率16.3%。结论拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者临床疗效显著,能提高生存质量,延长生命时间。
Objective To observe the clinical efficacy of lamivudine combined with adefovir dipivoxil in treatment of patients with decompensated hepatitis B cirrhosis and provide reference for clinical diagnosis and treatment. Methods The clinical data of patients with decompensated hepatitis B cirrhosis treated with lamivudine combined with adefovir dipivoxil from May 2006 to December 2010 were analyzed retrospectively. 234 patients with decompensated hepatitis B cirrhosis Divided into treatment group 96 cases and control group 138 cases, the treatment group routine liver protection, symptomatic treatment, given lamivudine 100mg and adefovir dipivoxil 10mg daily oral administration until the end of the patient’s follow-up, the control group by Routinely given liver protection and symptomatic treatment; the two groups in the number of hospitalizations, spontaneous peritonitis, hepatic encephalopathy, upper gastrointestinal bleeding, the incidence of primary hepatocellular carcinoma, survival and Child-pugh score changes, statistics Analysis using t test and χ2 test. Results There were significant differences in the number of hospitalizations, spontaneous peritonitis, hepatic encephalopathy, upper gastrointestinal bleeding, incidence of primary hepatocellular carcinoma, and survival rate between the two groups (P <0.01). In the antiviral treatment group 37 cases of grade A-B were transferred from child-pugh to 56.1% of Grade A cases, 10 cases of Grade C to 33 cases of Grade B, and 33 cases of Grade B to non-antiviral In 18 cases, the conversion rate was 20.2%. In the case of Grade C, 8 cases were converted to Grade B, and the conversion rate was 16.3%. Conclusion lamivudine combined with adefovir dipivoxil treatment of decompensated hepatitis B patients with significant clinical efficacy of liver cirrhosis, can improve the quality of life and prolong life time.