Effect of ursodeoxycholi acid combined with adefovir dipivoxil in treating hepatitis B cirrhosis
Author(s): Yuan Jianfeng, Jiang Ying'an, Zhang Cuifang, Zhang Zhiyong
Pages: 1618-1622
Year: 2015 Issue: 11
Journal: China Medicine
Keyword: Hepatitis; type B; Liver cirrhosis; Ursodeoxycholi acid; Adefovir dipivoxil; Quality of life;
Abstract: Objective To investgate the effect of ursodeoxycholi acid combined with adefovir dipivoxil in treating hepatitis B cirrhosis.Methods Sixty-five patients with hepatitis B cirrhosis in decompensated stage confirmed by needle biopsy and serological test from October 2012 to December 2014 were randomly divided into observation group (33 cases) given oral administration of adefovir dipivoxil (10 mg/d, 1 time/d) and ursodeoxycholi acid (250 mg/d, 2 times/d), and control group (32 cases) given adefovir dipivoxil (10 mg/d, 1 time/d);both groups were treated with comprehensive treatment and the treatment was lasted for 48 weeks.Before and 12, 24, 48 weeks after treatment, the hepatitis B virus (HBV) DNA level, alanine aminotransferase (ALT) , total bilirubin (TBIL),γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), globulin (GLO) were measured;the score of chronic liver disease questionnaire (CLDQ) (including abdominal symptoms, fatigue, systemic symptoms, activity ability, emotional function, anxious) were assessed;the negative conversion rates of HBV e antigen (HBeAg) and HBV DNA, the disappearance rate of ascites were observed.Results The HBV DNA level had no significant difference between groups before treatment (P ＞ 0.05).The HBV DNA levels in observation group 12,24 and 48 weeks after treatment were significantly lower than those in control group [(3.5 ± 0.9) lg copies/ml vs (4.3 ± 1.2) lg copies/ml, (3.3 ± 0.7) lg copies/ml vs (3.9 ± 0.9) lg copies/ml, (3.0 ± 0.5) lg copies/ml vs (3.3 ± 0.9) lg copies/ml] (P ＜ 0.05).The negative conversion rates of HBeAg and HBV DNA in observation group 12, 24 and 48 weeks after treatment were significantly higher than those in control group [HBeAg: 21.2％ (7/33) vs12.5％ (4/32), 33.3％ (11/33)vs25.0％ (8/32),45.5％ (15/33)vs34.4％ (11/32);HBV DNA : 36.4％ (12/33) vs 25.0％ (8/32), 57.6％ (19/33) vs 40.6％ (13/32), 78.8％ (26/33) vs 62.5％ (20/32)] (P ＜ 0.05).The levels of ALT, TBIL, γ-GT, ALP, GLO had no significant differences between groups before treatment (P ＞ 0.05);they were significantly lower in observation group than those in control group after 12, 24 and 48 weeks after treatment [ALT: (29 ±9) U/L vs (34 ± 12) U/L, (20 ±6) U/L vs (30 ± 8) U/L, (14 ±5) U/L vs (22 ±7) U/L;TBIL: (17 ±6) μmol/L vs (30 ±8) μmol/L, (15 ±4) μmol/L vs (23 ±6) μmol/L, (15 ±4) μmol/L vs (20 ±6) μmol/L;γ-GT: (41 ± 10) U/L vs (65 ± 13) U/L, (30 ± 9) U/Lvs (54±11) U/L, (17±6) U/Lvs (26±8) U/L;ALP: (36±9) U/Lvs (60±12) U/L, (25±8) U/Lvs (37±10) U/L, (19±7) U/Lvs (27±9) U/L;GLO: (8.8±1.8) g/Lvs (15.5±2.1) g/L,(4.5 ± 1.1) g/L vs (10.5 ± 1.9) g/L, (2.6 ± 0.7) g/L vs (7.8 ± 1.4) g/L] (P ＜ 0.05).The disappearance rate of ascites in observation group was significantly higher than that in control group 12, 24 and 48 weeks after treatment [30.3％ (10/33)vs 15.6％ (5/32), 45.5％ (15/33)vs 25.0％ (8/32), 75.8％ (25/33)vs 53.1％ (17/32)] (P ＜ 0.05).The scores of CLDQ before treatment had no significant differences between groups (P ＞ 0.05);the scores of abdominal symptoms, fatigue, systemic symptoms, activity ability, emotional function, anxious 24 and 48 weeks after treatment were all significantly improved than those before treatment in observation [(3.9±1.2), (3.3±0.9) scores vs (4.8±1.5) scores;(3.7±1.0), (3.0±0.8) scores vs (4.3±1.3) scores;(4.7 ±0.9), (2.8 ±0.7) scores vs (5.7 ± 1.0) scores;(4.0± 1.0), (3.1 ± 0.9) scores vs (4.7 ± 1.3) scores;(4.2 ± 1.3) , (3.3 ± 1.0) scores vs (4.7 ± 1.6) scores;(4.0 ± 1.3) , (3.2±0.9) scores vs (4.3±1.6) scores] and control group [(3.9 ±1.1) scores vs (4.4±1.5) scores;(3.8±1.1) scoresvs (4.2±1.3) scores;(4.6±0.8) scores vs (5.7±0.9) scores;(4.1±1.0) scoresvs (4.4 ± 1.3) scores;(4.0 ± 1.5) scores vs (4.5 ± 1.8) scores;(3.9 ± 1.2) scores vs (4.4 ± 1.5) scores] (P ＜ 0.05);they were significantly lower in observation group than those in control group 48 weeks after treatment (P ＜ 0.05).Conclusion Ursodeoxycholi acid combined with adefovir dipivoxil can effectively inhibit the HBV DNA level, increase the negative converse rate of HBeAg and improve the life quality in patients with hepatitis B cirrhosis.
Pages: 1618-1622
Year: 2015 Issue: 11
Journal: China Medicine
Keyword: Hepatitis; type B; Liver cirrhosis; Ursodeoxycholi acid; Adefovir dipivoxil; Quality of life;
Abstract: Objective To investgate the effect of ursodeoxycholi acid combined with adefovir dipivoxil in treating hepatitis B cirrhosis.Methods Sixty-five patients with hepatitis B cirrhosis in decompensated stage confirmed by needle biopsy and serological test from October 2012 to December 2014 were randomly divided into observation group (33 cases) given oral administration of adefovir dipivoxil (10 mg/d, 1 time/d) and ursodeoxycholi acid (250 mg/d, 2 times/d), and control group (32 cases) given adefovir dipivoxil (10 mg/d, 1 time/d);both groups were treated with comprehensive treatment and the treatment was lasted for 48 weeks.Before and 12, 24, 48 weeks after treatment, the hepatitis B virus (HBV) DNA level, alanine aminotransferase (ALT) , total bilirubin (TBIL),γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), globulin (GLO) were measured;the score of chronic liver disease questionnaire (CLDQ) (including abdominal symptoms, fatigue, systemic symptoms, activity ability, emotional function, anxious) were assessed;the negative conversion rates of HBV e antigen (HBeAg) and HBV DNA, the disappearance rate of ascites were observed.Results The HBV DNA level had no significant difference between groups before treatment (P ＞ 0.05).The HBV DNA levels in observation group 12,24 and 48 weeks after treatment were significantly lower than those in control group [(3.5 ± 0.9) lg copies/ml vs (4.3 ± 1.2) lg copies/ml, (3.3 ± 0.7) lg copies/ml vs (3.9 ± 0.9) lg copies/ml, (3.0 ± 0.5) lg copies/ml vs (3.3 ± 0.9) lg copies/ml] (P ＜ 0.05).The negative conversion rates of HBeAg and HBV DNA in observation group 12, 24 and 48 weeks after treatment were significantly higher than those in control group [HBeAg: 21.2％ (7/33) vs12.5％ (4/32), 33.3％ (11/33)vs25.0％ (8/32),45.5％ (15/33)vs34.4％ (11/32);HBV DNA : 36.4％ (12/33) vs 25.0％ (8/32), 57.6％ (19/33) vs 40.6％ (13/32), 78.8％ (26/33) vs 62.5％ (20/32)] (P ＜ 0.05).The levels of ALT, TBIL, γ-GT, ALP, GLO had no significant differences between groups before treatment (P ＞ 0.05);they were significantly lower in observation group than those in control group after 12, 24 and 48 weeks after treatment [ALT: (29 ±9) U/L vs (34 ± 12) U/L, (20 ±6) U/L vs (30 ± 8) U/L, (14 ±5) U/L vs (22 ±7) U/L;TBIL: (17 ±6) μmol/L vs (30 ±8) μmol/L, (15 ±4) μmol/L vs (23 ±6) μmol/L, (15 ±4) μmol/L vs (20 ±6) μmol/L;γ-GT: (41 ± 10) U/L vs (65 ± 13) U/L, (30 ± 9) U/Lvs (54±11) U/L, (17±6) U/Lvs (26±8) U/L;ALP: (36±9) U/Lvs (60±12) U/L, (25±8) U/Lvs (37±10) U/L, (19±7) U/Lvs (27±9) U/L;GLO: (8.8±1.8) g/Lvs (15.5±2.1) g/L,(4.5 ± 1.1) g/L vs (10.5 ± 1.9) g/L, (2.6 ± 0.7) g/L vs (7.8 ± 1.4) g/L] (P ＜ 0.05).The disappearance rate of ascites in observation group was significantly higher than that in control group 12, 24 and 48 weeks after treatment [30.3％ (10/33)vs 15.6％ (5/32), 45.5％ (15/33)vs 25.0％ (8/32), 75.8％ (25/33)vs 53.1％ (17/32)] (P ＜ 0.05).The scores of CLDQ before treatment had no significant differences between groups (P ＞ 0.05);the scores of abdominal symptoms, fatigue, systemic symptoms, activity ability, emotional function, anxious 24 and 48 weeks after treatment were all significantly improved than those before treatment in observation [(3.9±1.2), (3.3±0.9) scores vs (4.8±1.5) scores;(3.7±1.0), (3.0±0.8) scores vs (4.3±1.3) scores;(4.7 ±0.9), (2.8 ±0.7) scores vs (5.7 ± 1.0) scores;(4.0± 1.0), (3.1 ± 0.9) scores vs (4.7 ± 1.3) scores;(4.2 ± 1.3) , (3.3 ± 1.0) scores vs (4.7 ± 1.6) scores;(4.0 ± 1.3) , (3.2±0.9) scores vs (4.3±1.6) scores] and control group [(3.9 ±1.1) scores vs (4.4±1.5) scores;(3.8±1.1) scoresvs (4.2±1.3) scores;(4.6±0.8) scores vs (5.7±0.9) scores;(4.1±1.0) scoresvs (4.4 ± 1.3) scores;(4.0 ± 1.5) scores vs (4.5 ± 1.8) scores;(3.9 ± 1.2) scores vs (4.4 ± 1.5) scores] (P ＜ 0.05);they were significantly lower in observation group than those in control group 48 weeks after treatment (P ＜ 0.05).Conclusion Ursodeoxycholi acid combined with adefovir dipivoxil can effectively inhibit the HBV DNA level, increase the negative converse rate of HBeAg and improve the life quality in patients with hepatitis B cirrhosis.
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