阿德福韦酯联合苦参素治疗拉米夫定耐药慢性乙肝研究.docVIP

阿德福韦酯联合苦参素治疗拉米夫定耐药慢性乙肝研究 　　【摘要】目的：观察阿德福韦酯联合苦参素治疗拉米夫定耐药慢性乙型肝炎的的疗效。方法：将入选病例随机分为阿德福韦酯组和联合治疗组，阿德福韦酯组给予阿德福韦酯10 mg/d，连用48周。联合治疗组在阿德福韦酯组治疗基础上加用苦参素0.6 mg，静脉滴注，1次/日，连用48周。观察两组病毒应答率、生化应答率、HBeAg阴转及HBe转换率。结果：阿德福韦酯组24周时病毒应答率53%，生化应答率53%，HBeAg阴转率15%，HBe转换率6%。48周时病毒应答率59%，生化应答率68%，HBeAg阴转率26%，HBe转换率12%。联合治疗组24周时病毒应答率68%，生化应答率74%，HBeAg阴转率38%，HBe转换率21%，48周时病毒应答率85%，生化应答率91%，HBeAg阴转率56%，HBe转换率38%。结论：阿德福韦酯治疗对拉米夫定耐药的慢性乙型肝炎效果显著，且随时间延长而疗效提高。与苦参素联合，其疗效更加显著。 　　【关键词】乙型肝炎；慢性；拉米夫定；耐药；阿德福韦酯：苦参素 　　文章编号：1009-5519（2007）20-3011-02 中图分类号：R5 文献标识码：A 　　Effects of adefovir dipivoxil combined with kushensu in lamivudine-resistant patients with chronic hepatitis B 　　LU Kai-xue 　　（Jining Infectious Disease Hospital，Jining 272031，China) 　　【Abstract】Objective：To explore the effects of adefovir dipivoxil combined with kushensuin lamivudine-resistant patients with chronic hepatitis B. Methods：All selected cases of chronic hepatitis B were divided into two groups，adefovir dipivoxil treatment group and combination treatment group. In adefovir dipivoxil treatment group，adefovir dipivoxil was given 10 mg one time a day for 48 weeks. In combination treatment groupe，adefovir dipivoxil was given as the same， but kushensu was given 0.6 mg intravenous drip one time a day for 48 weeks. At the end of the therapy，the rates of viral response，chemical response，HBeAg negative and anti-HBe transformation were detected. Results：After 24 weeks of therapy，in adefovir dipivoxil treatment group and combination treatment group，the rates of viral response， chemical response，HBeAg negative and anti-HBe transformation was 53%，53%，15%，6% and 59%，68%，26%，12% respectively.And after 48 weeks of therapy，the rates of viral response，chemical response，HBeAg negative and anti-HBe transformation was 68%，74%，38%，21% and 85%，91%，56%，38% respectively. Conclusion：Adefovir dipivoxil is an effective treatment method for lamivudine-resistant patients with chronic hepatitis B， and the effect would be more significant by treating more long tim