拉米夫定联合阿德福韦酯治疗慢性乙型肝炎疗效观察.docVIP

拉米夫定联合阿德福韦酯治疗慢性乙型肝炎疗效观察[摘要] 目的:探讨拉米夫定联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法:慢性乙型肝炎患者90例,随机分为A、B、C三组,每组30例。A组采用拉米夫定联合阿德福韦酯治疗,B组采用拉米夫定治疗,C组采用阿德福韦酯治疗,观察三组患者治疗第12、24、48周时HBV-DNA和HBeAg转阴率、ALT复常率、HBeAg/抗-HBe血清转换率变化情况。结果:HBV-DNA转阴率A组3个时间点优于另外两组,B组第24周优于C组,差异有统计学意义(P0.05)。结论:拉米夫定与阿德福韦酯联合用药疗效优于单独使用拉米夫定或阿德福韦酯。 [关键词] 慢性乙型肝炎;拉米夫定;阿德福韦酯 [中图分类号] R512.6+2[文献标识码]A [文章编号]1673-7210(2009)07(a)-011-03 Clinical efficacy of Lamivudine and Adefovir in the treatment of patients with chronic hepatitis B FENG Bing (Department of Infection Medicine, the Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China) [Abstract] Objective: To investigate the clinical efficacy of Lamivudine and Adefovir in the treatment of patients with chronic hepatitis B. Methods: 90 patients with chronic hepatitis B were randomly divided into three groups, group A, B and C, with 30 patients in each group. Group A was treated with Lamivudine and Adefovir, group B was treated with Lamivudine and group C was treated with Adefovir. The changes of negative rate of HBV-DNA, HbeAg and ALT, the frequency of seroconversion of HBeAg/anti-HBe among the three groups at twelfth week, twenty-fourth week and forty-eighth week after treatment were observed. Results: The negative rates of HBV-DNA in group A at all the three time points were higher than the other two groups, group B was higher than group C at twenty-fourth week, and showed a significant difference (P0.05). Conclusion: Combination of Lamivudine and Adefovir in the treatment of chronic hepatitis B has advantage over Lamivudine or Adefovir treatment alone. [Key words] Hepatitis B, chronic; Lamivudine; Adefovir 慢性乙型病毒性肝炎是由乙型肝炎病毒(HBV)引起的一种严重危害人类健康的疾病,容易进展为肝硬化和肝癌。目前公认抗病毒治疗是慢性乙型肝炎治疗的关键,更是阻止肝硬化及肝癌发生的有效途径[1]。拉米夫定治疗慢性乙型肝炎的疗效和安全性已被确认,但长期应用后HBV易出现变异和发生耐药而成为治疗失败的主要原因。阿德福韦酯是新近应用于临床的一种核苷类抗病毒药物。近年来,我院采用拉米夫定联合阿德福韦酯治疗慢性乙型肝炎患者,取得较好的临床疗效,现报道并分析如下: 1 资料与方法 1.1 研究对象 选择2007年2月～2009年2月我院收治的门诊和住院的慢性乙型肝炎患者90例,所有患者均符合2000年全国病毒性肝炎会议修订的慢性乙型肝炎诊断标准[2],且具备下列条件:①H