ABSTRACT
Objective To evaluate the efficacy of lamivudine and adefovir in the treatment of patients with decompensated hepatitis B cirrhosis . Methods 90 cases of patients with hepatitis B cirrhosis of the liver decompensation period from August 2013 to June 2015 in our hospital were researched.According to the random number table method divided into observation group and control group , each of 45 cases, the total course of treatment was one year.The observation group was treated with lamivudine combined with adefovir dipivoxil , control group was treated with lamivudine.The clinical effect, the indexes of liver function, the changes of HBV-DNA and Child-pugh score were compared between the two groups after treatment.Results After treatment, the total effective rate of the observation group ( 93.33%) was obviously higher than that of control group (48.89%), the difference was statistically significant (P<0.05), the observation group alanine amino acid, total bilirubin, aspartate aminotransferase were (71.23 ±21.32)U/L, (28.32 ±4.65)Umol/lL, (4.65 ±9.25)U/L, they were significantly lower than control group (111.54 ±16.25)U/L, (46.53 ±4.89 ) Umol/L, ( 4.89 ±12.11 ) U/L, the observation group albumin ( 39.82 ±2.62 ) g/L was significantly higher than control group (35.55 ±2.22)g/L, the difference was statistically significant (P<0.05), after treatment, the observation group hepatitis b HBV DNA levels, Dhild pugh score (2.78 ±0.45)log10 copies/mL, (6.12 ±1.23) were significantly lower than the control group (3.89 ±0.65)log10 copies/mL, (7.89 ± 1.21)scores, the difference was statistically significant (P <0.05).Conclusion The combination of lamivudine and adefovir dipivoxil significantly decompensated hepatitis B cirrhosis has a curative effect, it could effectively improve the patient's liver function, Dhild-pugh score, HBV-DNA level.
ABSTRACT
Objective To investigate the immune response of Adefovir ester combine the Fuzheng Huayu in the process of the treatment of chronic hepatitis B.Methods 100 cases with CHB from March 2010 to October 2014 collected in outpatients clinic or hospital were randomly divided into Adefovir ester treatment group and Adefovir ester joint the Fuzheng Huayu treatment group.Levels of AST, ALT, HBsAg and HBV DNA pre-and-post treatment were detected.CD3-CD56 +,CD244 +NK,CD3 +,CD3 +CD4 +,CD3 +CD8 +T cells and the contents of CD 4 +T cells in serum of two groups were measured by flow cytometry analysis.Results The levels of AST、ALT、HBV-DNA of two group post-treatment were all significantly lower than pre-treatment(P<0.05),and the level of AST and ALT in Adefovir ester and Fuzhengh Huayu treatment group at 3 months and 6 months were obviously lower than Adefovir ester treatment group.HBV-DNA contents between two groups had no significant difference.HbsAg levels of two groups were all significantly increased after 6,9,12 months’treatment (P<0.05),While there was no significant difference between two groups post-treatment.CD3-CD56 +cell at 6,9,12 months in two groups were all higher than pre-treatment(P<0.05), which in Adefovir ester and Fuzhengh Huayu treatment group were more higher than Adefovir ester treatment group(P<0.05).CD244 +NK,CD3 +T cell, CD3 +CD4 +Tcell at each point post-treatment in peripheral blood of two groups were all increased significantly(P<0.05),which in Adefovir ester and Fuzhengh Huayu treatment group increased more obviously than Adefovir ester treatment group (P<0.05).However, CD3 +CD8 +cells were reduced obviously after treatment in two groups(P<0.05), which besides 3 month point, its ratio in Adefovir ester and Fuzhengh Huayu treatment group decreased more significantly than Adefovir ester treatment group at other points( P<0.05 ).Cytokines in serum of two groups were all increased significantly post-treatment ( P<0.05 ) , which in Adefovir ester and Fuzhengh Huayu treatment group were more lower (P<0.05).Conclusion Adefovir ester and Fuzhengh Huayu treatment can improve the situation of AST, ALT, HBV DNA and HBsAg in patients with chronic hepatitis B,promote the expression of NK cells,T cells and Tcell secrited cytokines,and the efficacy is better than Adefovir estertreatment alone.