关键词: 乙型肝炎, 肝硬化, 拉米夫定, 阿德福韦酯, 治疗

Abstract: Objective To observe the effectiveness and safety of combination therapy and optimized therapy of lamivudine and adefovir dipivoxil in patients with hepatitis B virus-related decompensated cirrhosis. Methods 75 patients with hepatitis B virus-related decompensated liver cirrhosis received either combination therapy or optimized therapy of lamivudine and adefovir dipivoxil from 2010 to 2013,and the clinical effectiveness and safety after 48-week treatment in two groups were compared. Results At the end of 48 week treatment,the normalization rate of serum ALT and the loss of serum HBV DNA in combination therapy group were 84.0% and 89.3%,respectively,much higher than those（46.0% and 50.7%,respectively,P<0.05） in patients receiving optimized therapy;the number of Child-Pugh class A increased by 22.7% and that of Child-Pugh class C reduced by 12% in combination therapy group,greater than 10.7% and 5.3% in optimized therapy group（P<0.05 for both）;the ascites subsided in 76.0% of patients in combination therapy group,significantly higher than 56.0% in optimized therapy group（P<0.05）;there was no difference in changes of renal function index and plasma creatinine kinase throughout the treatment between the two groups. Conclusions The combination of lamivudine and adefovir dipivoxil offers a better clinical outcome in patients with hepatitis B virus-related decompensated cirrhosis.

Key words: Hepatitis B, Liver cirrhosis, Lamivudine, Adefovir dipivoxil, Efficacy