分析不同核苷（酸）类似物初始治疗乙型肝炎肝硬化的临床疗效。

选取2010年8月至2013年8月于河北医科大学第三医院感染科诊断为乙型肝炎肝硬化的患者共218例，随机分为拉米夫定联合阿德福韦酯治疗组（LA组）、替比夫定联合阿德福韦酯组（TA组）、恩替卡韦单药治疗组（EN组）和对照组。分别给予不同抗病毒治疗，持续48周后检测患者相关肝功能以及肝硬化指标并进行综合评价。

经48周的治疗，四组患者的肝功能均有一定程度改善，抗病毒治疗的患者优于对照组，而LA和TA两组联合治疗方式优于EN组单药治疗，差异均有统计学意义（F = 9.775、10.148，P = 0.012、0.008）；四组患者的病毒复制均有所降低，抗病毒治疗的患者优于对照组，而LA组和TA组两组联合治疗方式优于EN组单药治疗，差异均具有统计学意义（F = 11.275、12.198、15.645，P = 0.037、0.016、0.003）；四组患者的肝硬化程度亦有所降低，抗病毒治疗的患者优于对照组，而LA组和TA组两组联合治疗方式优于EN组单药治疗，差异均具有统计学意义（F = 13.534、11.009、12.756，P = 0.015、0.022、0.019）。

使用不同核苷（酸）类似物进行抗病毒治疗后，乙型肝炎肝硬化患者的肝功能以及肝硬化程度有明显改善，且联合用药优于单药治疗。

To explore the effect and safety of the different nucleos(t)ide analogues for the initial treatment on hepatitis B (HBV) patients with cirrhosis.

Total of 218 patients diagnosed with HBV with cirrhosis between August 2010 and August 2013 in The Third Hospital of Hebei Medical University were randomly divided into the lamivudine combined with adefovir (LA) group, the telbivudine combined with adefovir (LA) group, entecavir monotherapy (EN) group and the control group. The different antiviral therapy were given among groups for 48 weeks in order to measure the related indexes on the liver cirrhosis.

After the treatment of 48 weeks, the liver function of patients in the four groups were improved to a certain extent, patients with antiviral treatment were better than that of control group, while the liver function of LA group and TA group were superior to the EN group single-agent therapy, with significant differences (F = 9.775, 10.148; P = 0.012, 0.008); the HBV DNA replications were reduced of patients in the four groups, patients with antiviral treatment was better than that of control group, while the reductions of the HBV DNA in LA group and TA group were superior to the EN group single-agent therapy, with significant differences (F = 11.275, 12.198, 15.645; P = 0.037, 0.016, 0.003). The degree of liver cirrhosis of patients in the four groups were improved to a certain extent, patients with antiviral treatment was better than that of control group, while the improvement of the liver’s cirrhosis degree in LA group and TA group were superior to the EN group single-agent therapy, with significant differences (F = 13.534, 11.009, 12.756; P = 0.015, 0.022, 0.019).

The liver function and the degree of cirrhosis improved significantly, and the combination method was superior to the single drug therapy after different nucleotide analogue antiviral treatment.