| 唐芬,龚星光,汤桂芳.阿德福韦酯联合拉米夫定治疗拉米夫定耐药的 HBeAg阳性慢性乙型肝炎患者临床疗效观察[J].安徽医药,2016,20(6):1170-1173. |
| 阿德福韦酯联合拉米夫定治疗拉米夫定耐药的 HBeAg阳性慢性乙型肝炎患者临床疗效观察 |
| Clinical curative effect of adefovir and lamivudine in treatment of lamivudine resistant patients with HBeAg positive chronic hepatitis B |
| 投稿时间：2015-10-29 |
| DOI： |
| 中文关键词: 乙型肝炎,慢性 拉米夫定 阿德福韦酯 治疗结果 |
| 英文关键词: Hepatitis b,chronic Lamivudine Adefovir Treatment outcome |
| 基金项目:广西自然科学基金项目(2015jjAA 40256)阿德福韦酯联合拉米夫定治疗拉米夫定耐药的 HBeAg阳性慢性乙型肝炎患者临床疗效观察唐芬,龚星光,汤桂芳 (广西壮族自治区南溪山医院感染性疾病科,广西 桂林 541002)阿德福韦酯联合拉米夫定治疗拉米夫定耐药的 HBeAg 阳性慢性乙型肝炎患者临床疗效观察 唐芬,龚星光,汤桂芳 |
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| 中文摘要: |
| 目的 观察阿德福韦酯联合拉米夫定治疗拉米夫定耐药的HBeAg阳性慢性乙型肝炎的临床疗效,为临床抗病毒方案的制定提供参考。方法 选取在该院就诊的拉米夫定耐药的HBeAg阳性慢性乙型肝炎患者78例,分为观察组和对照组各39例。对照组单用阿德福韦酯口服治疗,观察组在对照组治疗方案的基础上,加用拉米夫定口服治疗,疗程为48周。分别在治疗前、治疗12、24、36、48周对两组患者血清中谷丙转氨酶(ALT)、HBV血清学指标和HBV-DNA载量相比较。结果 两组患者治疗12、24、36、48周的HBV-DNA载量、ALT水平均显著低于治疗前；其中,观察组治疗24周的HBV-DNA载量为(4.02±1.07)log10 copy·mL-1,治疗36周的HBV-DNA载量为(3.40±1.06)log10 copy·mL-1,治疗48周的HBV-DNA载量为(3.13±1.08)log10 copy·mL-1,均显著低于对照组(均P＜0.05)；观察组治疗48周的ALT水平显著低于对照组(P＜0.05)；观察组治疗24周的HBV-DNA转阴率为56.41%,治疗36周的HBV-DNA转阴率为64.10%,治疗48周的HBV-DNA转阴率为76.92%,均显著高于对照组(均P＜0.05)；观察组治疗24周的ALT复常率为71.79%,治疗36周的ALT复常率为79.49%,治疗48周的ALT复常率为94.87%,均显著高于对照组(P＜0.05)。结论阿德福韦酯联合拉米夫定对拉米夫定耐药的HBeAg阳性慢性乙型肝炎具有良好的临床疗效,可提高其病毒学和生化学应答率,且安全性较高,值得推广应用。 |
| 英文摘要: |
| Objective To observe the clinical curative effect of adefovir and lamivudine in treatment of lamivudine resistant patients with HBeAg positive chronic hepatitis B,and to provide the reference for clinical antiviral scheme.Methods 78 patients were randomly divided into observation group and control group with 39 cases in each.Control group was treated with adefovir dipivoxil orally,the observation group based on the treatment scheme of the control group,combined with lamivudine oral therapy,treatment for 48 weeks.Respectively,before treatment,12 weeks,24 weeks,36 weeks and 48 weeks for the two groups of alanine aminotransferase (ALT),HBV markers and HBV-DNA load,compared two groups of patients with ALT,HBV-DNA load and after treatment of biochemical,serological and virological response.Results The two groups were treated for 12 weeks,24 weeks,36 weeks and 48 weeks of HBV-DNA load,ALT levels were significantly lower than those before therapy (P＜0.05);the observation group for 24 weeks of HBV-DNA load was (4.02±1.07) log10 copy·mL-1,36 weeks of treatment HBV-DNA loading was (3.40±1.06) log10 copy·mL-1,48 weeks of treatment HBV-DNA loading was (3.13±1.08) log10 copy·mL-1,were significantly lower than those in the control group (P＜0.05);observationgroup of 48 weeks of treatment ALT was significantly lower than that of the control group(P<0.05);the observation group for 24 weeks of HBV-DNA negative rate was 56.41%,for 36 weeks the HBV-DNA negative rate was 64.10%,and 48 weeks of treatment HBV-DNA negative rate was 76.92%,significantly higher than that of control group (all P<0.05);the observation group for 24 weeks.The recovery rate of ALT was 71.79%,36 weeks of treatment the recovery rate of ALT was 79.49%,48 weeks of treatment the recovery rate of ALT was 94.87%,significantly higher than control group(P＜0.05).Conclusions Adefovir dipivoxil combined with lamivudine in lamivudine resistant HBeAg positive chronic hepatitis Bhas good curative effect,can improve the virological and biochemical response rate,and high safety,and is worthy of popularization and application. |
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