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目的比较2种方法治疗失代偿期乙肝肝硬化的临床效果。方法将失代偿期乙肝肝硬化患者92例随机分为甲、乙组各46例。甲组给予恩替卡韦联合阿德福韦酯治疗,乙组给予替比夫定治疗。检测2组治疗前后肝功能相关指标,比较2组HBV DNA转阴率及HBe Ag血清转换率。结果经48周治疗,2组患者血清白蛋白(ALB)、凝血酶原活动度(PTA)均上升,丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平显著下降,差异均有统计学意义(P<0.01);2组治疗后ALB、ALT、TBIL及PTA水平比较差异均无统计学意义(P>0.05)。2组治疗12、24、48周HBV DNA转阴率、HBe Ag血清转换率逐渐升高,但2组间差异无统计学意义(P>0.05)。结论在失代偿期乙肝肝硬化临床治疗中,恩替卡韦联合阿德福韦酯与替比夫定单用均能明显改善肝功能,疗效相当,联合用药不比单独用药效果明显。
Objective To compare the clinical effects of two methods in decompensated hepatitis B cirrhosis. Methods 92 patients with decompensated hepatitis B cirrhosis were randomly divided into A and B groups of 46 cases. Group A was given entecavir plus adefovir dipivoxil, and group B was treated with telbivudine. The indexes of liver function in two groups before and after treatment were detected, and the negative rate of HBV DNA and the rate of HBeAg seroconversion in two groups were compared. Results Serum albumin (ALB), prothrombin activity (PTA) and alanine aminotransferase (ALT) and total bilirubin (TBIL) levels were significantly decreased in both groups after 48 weeks of treatment, the difference was (P <0.01). There was no significant difference in ALB, ALT, TBIL and PTA between the two groups after treatment (P> 0.05). The rates of HBV DNA negative conversion and HBeAg seroconversion in the two groups at 12, 24 and 48 weeks increased gradually, but there was no significant difference between the two groups (P> 0.05). Conclusions In the clinical treatment of decompensated hepatitis B cirrhosis, entecavir combined with adefovir dipivoxil and telbivudine alone can significantly improve liver function, with comparable efficacy, the combination of drugs than single drug effect is obvious.