ABSTRACT
Objective To evaluate the effect of the combination of lamivudine and adefovir dipivoxil on the treatment of decompensated hepatitis B cirrhosis patients. Methods One hundred thirty-six patients with decompensated hepatitis B cirrhosis were randomly administered the combination of lamivudine and adefovir dipivoxil (combination group), only lamivudine( LAM group)and only adefovir dipivoxil (ADV group). The liver founction tests, ChildPugh scores and the rate of negative conversion for the serum HBV-DNA were measured at baseline,six months after therapy and 12 months after therapy. Results The rate of negative conversion for the serum HBV-DNA ( ＜ 1 ×103cop/ml)of combination group were 78.3% and 85.2% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of LAM group were 62. 1% and 57.8% respectively at six and twelve months after therapy. The rates of negative conversion for the serum HBV-DNA of ADV group were 41.3% and 53.6% respectively at six and twelve months after therapy. Compared with the LAM and ADV group, The rates of negative conversion for the serum HBV-DNA of combination group were higher. In addition, the rates of better conversion of liver function tests and Child-Pugh scores were higher in combination group than LAM and ADV groups.Conclusion The combination of lamivudine and adefovir dipivoxil could more effectively improve liver founction tests, Child-Pugh scores and the rates of negative conversion for the serum HBV-DNA in patients with decompensated hepatitis B cirrhosis than only lamivudine and only adefovir dipivoxil.
ABSTRACT
Objective To realise the clinical features and to reduce the diagnostic errors of hepatolenticular degeneration patients with liver injure. Methods Clinical manifestations, results of las tests and admitting diagnosis of 23 hepatolenticular degeneration cases were reviewed. Results All cases showed the elevation of serum transami-nase and/or total bilirubin. 17 cases(73.9% ) had manifestation of liver malfunction while nervous system symptoms were merely found in 2 cases. The decreased ceruloplasmin and elevated 24 hour urinary cuprum were detected in 23 and 21 cases respectively. Positive K-F rings were observed in 17 of 23 patients. Misdiagnosis rate of admitting diagno-sis exceeded 43.5%. 2 cases died after treating with penicillamine. Conclusion Liver injure that is one of the com-mon clinical features results in the diagnostic errors, but the combination detection will improve the accuracy of hepa-tolenticular degeneration.
ABSTRACT
Objective To study the effects of Interferon(IFN)in chronic hepatitis B patients genotype B and C.Methods 20 cases were genotype B ,23 cases were genotype C,all the patients were treated with 5 million units of IFN-a-lb,im,qod,for 12 months,viral markers,liver function and adverse drug reactions were observed.Results There was no statistically significant difference between B,C genotype in the negative conversion rate of HBV-DNA (60.0% ,39.1%),the negative conversion rate of HBeAg(42.9% ,30.8%),anti-HBe seroconversion rate(35.7% ,23.1 %)and the rate ALT normalization(85.0% ,73.9%)(t = 1.86,0.69,0.68 ,0.79,P ＞ 0.05).Conclusion The results suggested that therapeutic efficacy of IFN-α-lb was not significantly different between B,C genotypes.