【摘要】：目的探討聯(lián)合抗病毒治療對乙型肝炎肝硬化患者肝纖維化五項(xiàng)指標(biāo)的影響,為臨床抗病毒治療的療效提供參考。方法選擇確診的乙肝肝硬化患者60例,分為對照組和觀察組,每組各30例。對照組患者在綜合對癥、支持和保肝治療基礎(chǔ)上給予口服抗病毒藥物拉米夫定100 mg/d,1次/d;觀察組患者在對照組的治療基礎(chǔ)上給予口服阿德福韋酯10 mg/d,1次/d。治療期為48周,分別于試驗(yàn)開始前、第6、12、24、36周和48周抽取患者外周血對肝功能及層粘連蛋白、Ⅲ型前膠原、Ⅳ型膠原、透明質(zhì)酸酶和脯肽酶等反映肝纖維化的五項(xiàng)指標(biāo)進(jìn)行動(dòng)態(tài)觀察。結(jié)果觀察組患者治療有效率為76.7%,明顯高于對照組。2組患者在治療前后AST、ALT、A/G和TBIL水平隨著用藥時(shí)間的延長而均有所降低,且治療第36周和48周時(shí)組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組患者在治療前后LA、HA、IV-C、PCⅢ和PLD水平隨著用藥時(shí)間的延長而均有所降低。對照組患者在用藥第36周LA、HA、IV-C、PCⅢ和PLD與用藥前相比較明顯降低(P0.05)。觀察組患者上述各項(xiàng)指標(biāo)在第12周時(shí)與用藥前相比較均已出現(xiàn)明顯的降低,且差異有統(tǒng)計(jì)學(xué)意義;且在第24周時(shí),2組間LA、HA、PCⅢ和PLD含量比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論拉米夫定聯(lián)合阿德福韋酯抗病毒治療可有效降低乙肝肝硬化患者肝纖維化指標(biāo)的水平,起到緩解肝硬化進(jìn)程的作用。
[Abstract]:Objective to investigate the effect of combined antiviral therapy on liver fibrosis in patients with hepatitis B cirrhosis. Methods 60 patients with hepatitis B cirrhosis were divided into control group and observation group with 30 cases in each group. Patients in the control group were treated with oral antiviral drug lamivudine 100 mg / d once a day on the basis of comprehensive treatment support and liver protection while patients in the observation group were given oral adefovir 10 mg / d per day on the basis of treatment in the control group. The treatment period was 48 weeks. The peripheral blood was collected from the patients with liver function and laminin, type 鈪，

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