摘要
Abstract
Objective To compare the efficacy of entecavir(ENT) monotherapy and lamivudine(LAM) plus adefovir(ADV) combination therapy for hepatitis B cirrhosis for 144 weeks. Method 100 cases hepatitis B cirrhosis were randomly assigned to receive 144 weeks of treatment with 0.5 mg/day ENT(group A;n=50) or 100 mg/day LAM plus 10 mg/day ADV(group B;n=50). HBV DNA levels, liver and kidney function, HBV markers and gallbladder spleen B-P the area resistance gene sequencing detection of patients with viral rebound were detected from baseline to 144 weeks. Results ① two groups of baseline indicators were no significant difference. ②A group HBV DNA negative rate of 86.0% (43/50), 90.0% (45/50)at 12,24 weeks; B group were 66.0% (33/50), 74.0% (37/50) The difference between the two groups were statistically significant (x2 = 5.482, P = 0.019; x2 = 4.336, P = 0.037). at 48, 96, 144 weeks HBV DNA negative rate differences between the two groups were not statistically significant. ③There was no statistically significant difference between the two groups of ALT normalization rate at each time point. ④ 96,144 A group of HBeAg seroconversion rates were 17.1% (6/35), 20.0% (7/35); B group were 41.9% (13/31), 48.4% (15/31), the two between group differences were statistically significant (x2 = 4.929, P = 0.026; x2 = 5.961, P = 0.015). ⑤In the 144 weeks liver cancer in A group has 3 patients (6%) and B group has 1patient (2%), the difference was not statistically significant (x2 = 0.260, P = 0.610). ⑥ two groups of patients with baseline and 144 weeks ascites incidence differences were statistically significant (x2 = 4.882, P = 0.027, x2 = 7.294, P = 0.007). ⑦A group has no viral resistance occurred in 144 weeks;; B group one patient occurred drug-resistant, YMDD L180M, A181V, M204I, resistance rate of 2.0%.Conclusion single drug ENT and LAM plus ADV two groups program 144 weeks treatment in patients with liver cirrhosis can get higher virological, biochemical, and serological responses, a lower incidence of liver cancer, and drug resistance rate. However, the role of the ENT early inhibition of viral superior to the combination therapy. Serologic responses combination therapy is superior to ENT.关键词
肝炎,乙型,慢性/肝硬化/恩替卡韦/拉米夫定/阿德福韦酯Key words
Hepatitis B/Cirrhosis/Entecavir/Lamivudine/Adefovir dipivoxil
