| 摘要: |
| 目的比较初始联合拉米夫定和阿德福韦酯与恩替卡韦单药治疗失代偿期乙型肝炎肝硬化患者的疗效和对肾功能的影响。方法将72例失代偿期乙型肝炎肝硬化患者随机等分为联合组和单药组。联合组口服拉米夫定和阿德福韦酯,单药组口服恩替卡韦。比较两组治疗后12个月的肝功能、Child-Pugh评分及治疗后6个月、12个月HBV DNA阴转率,同时比较两组治疗后12个月的血清肌酐(Cr)和估算肾小球滤过率(e GFR)。结果治疗后两组肝功能、ChildPugh评分和HBV DNA阴转率比较差异无统计学意义(P>0.05)。治疗后12个月,联合组Cr水平高于治疗前、e GFR低于治疗前,差异有统计学意义(P<0.05);单药组Cr、e GFR治疗前后变化不明显,差异无统计学意义(P>0.05);两组比较,联合组Cr高于单药组、e GFR低于单药组,差异均有统计学意义(P<0.05)。结论初始联合拉米夫定和阿德福韦酯与恩替卡韦单药治疗失代偿期乙型肝炎肝硬化疗效无差异,但恩替卡韦单药治疗在肾安全性方面优于拉米夫定和阿德福韦酯联合治疗。 |
| 关键词: 乙型肝炎 肝硬化 拉米夫定 阿德福韦酯 恩替卡韦 |
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| Efficacy and Renal Function Impact Comparison of Two Anti-Hepatitis B Virus Therapies in Patients with Hepatitis B Cirrhosis |
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Yang Jun;Wei Min;Shi Han1,2
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1.Department of infectious diseases,the First Affiliated Hospital of Chengdu Medical College;2.Department of public health,Chengdu Medical College
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| Abstract: |
| Objective To compare initial combination medication of Lamivudine and Adefovir Dipivoxil with Entecavir monotherapy in patients with decompensated hepatitis B cirrhosis,in terms of efficacy and renal function impact. Methods 72 cases of patients with decompensated hepatitis B cirrhosis were randomly as well as equally divided into combination medication group and monotherapy group. Patients in combination medication group took Lamivudine and Adefovir Dipivoxil orally,while patients in monotherapy group took Entecavir orally. Liver function as well as Child-Pugh scores of the two groups after 12-months treatment and HBV DNA negative rates of the two groups after 6-and 12-months treatment were compared. Besides,serum creatinine(Cr) and estimated glomerular filtration rate(e GFR) of the two groups after 12-months treatment were also compared. Results After treatment,there were no statistically significant difference between the two groups in terms of liver function,Child-Pugh scores and HBV DNA negative rates(P>0. 05). After 12-months treatment,Cr of combination medication group was higher than pretreated level and e GFR was lower than pretreated level,the difference being statistically significant(P<0. 05),while in monotherapy group,there was no significant change in Cr or e GFR,compared with pretreated level,the difference being not statistically significant(P > 0. 05).When comparing the two groups,Cr of combination medication group was higher than monotherapy group,e GFR of combination therapy group was lower than monotherapy group,the difference being statistically significant(P<0. 05). Conclusion There is no difference in curative effect between initial combination medication of Lamivudine and Adefovir Dipivoxil,and Entecavir monotherapy in the treatment of hepatitis B cirrhosis,but Entecavir monotherapy was prior to combination medication of Lamivudine and Adefovir Dipivoxil in terms of renal protection. |
| Key words: hepatitisB cirrhosis lamivudine adefovirdipivoxil entecavir |
