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[摘要] 目的：观察阿德福韦酯(ADV)联合拉米夫定(LAM)治疗失代偿期乙肝肝硬化的疗效和安全性。方法：46例患者均在保肝、对症、支持、防治并发症等综合治疗的基础上加用阿德福韦酯(ADV)10 mg和拉米夫定(LAM)100 mg口服，疗程48周。比较患者在治疗前、后的临床表现、生化学指标、病毒学改变、Child-Pugh分级情况。结果：43例(93.48%)患者经治疗后病情缓解并稳定，肝功能明显好转或恢复正常，Child-Pugh积分下降，所有患者HBV DNA水平明显下降，部分患者出现HBeAg/抗HBe血清转换。结论：阿德福韦酯(ADV)联合拉米夫定(LAM)治疗失代偿期乙肝肝硬化可迅速显著地抑制HBV DNA的复制，促进肝功能的恢复，使Child-Pugh积分下降，缓解病情发展，并且药物安全性好。
[关键词] 乙型肝炎；失代偿期肝硬化；阿德福韦酯；拉米夫定
[中图分类号] R512.6 [文献标识码]B[文章编号]1674-4721(2011)06(a)-068-03
Clinical research on adenovirus and lamifudine in treating 46 cases of decompensate liver cirrhosis result from Hepatitis B
WANG Bin, CAO Yanping, ZHANG Hongxu, XU Honghua
Department of Hepatology, Luohe Central Hospital, Henan Province, Luohe 462000, China
[Abstract] Objective: To evaluate the clinical efficacy and safety of adenovirus and lamifudine therapy in 46 cases of decompensate liver cirrhosis result from Hepatitis B. Methods: There were 46 cases of decompensate liver cirrhosis result from Hepatitis B patients, which were treated with adenovirus (ADV) 10 mg and lamifudine (LAM) 100 mg on the basis of system treatments, such as protecting liver function, supportive and symptomatic and preventing complications, for 48 weeks. Studied the change of the clinical symptoms, biochemist indexes, serum HBV DNA level, Child-Pugh degree scores before and after the therapy. Results: After the treatment, 43 (93.48%) patients′ clinical symptoms and liver functions were improved, the Child-Pugh degree scores were decreased. The serum HBV DNA levels of all the 46 patients were decreased. The serum HBeAg diverts to HBeAb in part of the patients. Conclusion: Adenovirus and lamifudine in treating decompensate liver cirrhosis result from Hepatitis B can evidently inhibit the HBV DNA copy, improve the liver function, and decrease the Child-Pugh degree scores. Both drugs are safety.
[Key words] Hepatitis B; Decompensate liver cirrhosis; Adenovirus; Lamifudine
失代偿期乙肝肝硬化属晚期肝病，并发症多，治疗困难，预后差，有报道5年生存率仅为14% ......
