替诺福韦酯和拉米夫定联合阿德福韦酯对乙型肝炎肝硬化患者疗效的比较

摘要/Abstract

摘要： 目的比较替诺福韦酯和拉米夫定联合阿德福韦酯对乙型肝炎肝硬化患者的疗效,为乙型肝炎肝硬化治疗提供一定的临床依据。方法选取我院乙型肝炎肝硬化患者共130例,实验组和对照组各65例。实验组接受替诺福韦酯(300 mg/d),对照组予以阿德福韦酯(10 mg/d)联合拉米夫定(100 mg/d),两组共治疗12个月,观察比较治疗前后肝功能、血清病毒学指标及甲胎蛋白(AFP)水平变化。结果经过治疗以后,两组患者ALT,AST,总胆红素(TBil),Child-Pugh评分,甲胎蛋白(AFP)较治疗前均显著降低,但实验组较对照组降低更加明显,其差异有统计学意义(P<0.05)。治疗后,实验组HBV DNA、失代偿好转率明显高于对照组,其差异有统计学意义(P<0.05)。两组患者在死亡率,肝癌发生率上差异无统计学意义(P>0.05)。结论替诺福韦酯对于乙型肝炎肝硬化患者疗效优于拉米夫定联合阿德福韦酯,耐药发生率低。对于拉米夫定联合阿德福韦酯疗效欠佳的乙型肝炎肝硬化患者可以考虑改用替诺福韦酯。

关键词: 乙型肝炎肝硬化, 替诺福韦酯, 拉米夫定, 阿德福韦酯

彭福江,陈福生,张天晓. 替诺福韦酯和拉米夫定联合阿德福韦酯对乙型肝炎肝硬化患者疗效的比较[J]. 肝脏, 2017, 22(6): 535-537.

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