关键词: 肝硬化, 乙型肝炎, 阿德福韦酯, 恩替卡韦, 细胞因子, 疗效

Abstract: Objectives To investigate the efficacy of combination of adefovir dipivoxil and entecavir in treatment of elderly patients with decompensated hepttitis B-induced liver cirrhosis. Methods A total of 84 elderly patients with decompensated hepttitis B-induced liver cirrhosis in our hospital between January 2014 and January 2015 were recruited in this study. Patients were divided into two groups，and 42 patients were treated with adefovir dipivoxil combined with entecavir，and another 42 patients in the control group were treated with adefovir dipivoxil alone. The liver function index and negative rate of serum HBV DNA were compared. Serum tumor necrosis factor-α （TNF-α） and interleukin-10 （IL-10） were measured by ELISA. Results At the end of 48 week treatment，serum levels of total bilirubin in combination and in adefovir-treated groups were（28.3±4.2） μmol/L and （47.4±6.2） μmol/L，ALT were （71.3±19.8） U/L and （109.7±16.1） U/L，AST were （65.3±17.4） U/L and（98.3±21.6） U/L，respectively，all having statistically significant differences（P<0.05）；the negative rates of serum HBV DNA at week 24 and week 48 in combination group was 35.7% and 61.9%，respectively，both much higher than（13.0% and 33.3%，P<0.05） in the adefovir-treated group；serum levels of TNF-α in combination and adefovir-treated group after treatment were（22.4±16.8） pg/ml and （32.8±22.3） pg/ml，respectively，and serum levels of IL-10 were（21.2±3.6） pg/ml and（16.2±3.4） pg/ml，respectively，both having statistically significant differences （P<0.05）. Conclusion Adefovir dipivoxil combined with entecavir can improve the liver function index and increase negative rates of serum HBV DNA in elderly patients with decompensated hepatitis B-induced liver cirrhosis，which is obviously superior to adefovir dipivoxil therapy alone.

Key words: Liver cirrhosis, Hepatitis B, Adefovir dipivoxil, Entecavir, Cytokines, Efficacy