摘要
目的了解替比夫定联合阿德福韦酯治疗阿德福韦酯耐药慢性乙型肝炎的疗效。方法74例慢性乙型肝炎患者均为阿德福韦酯治疗24周以上未改善者，随机分为联合治疗组28例，单药组24例，对照组22例。联合组给予替比夫定600mg／d，阿德福韦酯片10mg／d；单药组换用替比夫定片600mg／d；对照组仍给予阿德福韦酯片10mg／d。3组均继续治疗2，4周，观察治疗第12周、24周肝功能复常率、HBVDNA转阴率及HBeAg转阴率。结果治疗12周时，联合治疗组肝功能复常率、HBVDNA转阴率及HBeAg转阴率分别为60．7％、53．5％和28．6％，显著优于单药组的37．5％、25．0％和12．5％，三者比较差异均有统计学意义（X^2=4．7，P〈0．05；X^2=5．1，P〈0．01；X^2=6．4，P〈0．01）；而单药组肝功能复常率、HBVDNA转阴率均明显优于对照组，且差异有统计学意义（X^2=7．2、8．9，P〈0．01）。治疗24周时，单药组肝功能复常率、HBVDNA阴转率及HBeAg阴转率与对照组比较差异有统计学意义（X^2=18．7、12．6、22．0，P〈0．01）。联合组肝功能复常率、DNA阴转率和HBeAg阴转率与单药组比较差异均有统计学意义（X^2=4．5、5．7、6．1，P〈0．01）。结论替比夫定联合阿德福韦酯早期干预阿德福韦酯耐药的慢性乙型肝炎近期疗效显著。
Objective To observe the effect of telbivudine combined with adefovir dipivoxil in the treatment of adefovir dipivoxil-resistant chronic hepatitis B. Methods 74 chronic hepatitis B patients who were given adefovir dipivoxil for 24 weeks with no improvement were divided into 3 groups. Combination group（28 cases）were given telbivudine （600 mg/d） and adefovir dipivoxil （10 mg/d）. Telbivudine group（24 cases） were given telbivudine （600 mg/d）. The control group（22 eases）were given adefovir dipivoxil （10 mg/d）. All the patients were treated for 24 weeks. The normalization rate of liver function, HBV DNA negative rate and HBeAg seroconversion rate were compared after 12-week and 24-week therapy. Results After 12-week therapy, the normalization rate of liver function, HBV DNA negative rate and HBeAg seroconversion rate were 60.7%, 53.5%, 28.6% in combination group, and were significantly better than those in telbivudine group（37.5%, 25.0%, 12.5%）（X^2 = 4.7, P 〈 0.05; X^2 = 5.1, P 〈 0.01; X^2 = 6.4, P 〈 0.01 ）. The normalization rate of liver function, HBV DNA negative rate in telbivudine group were significantly better than those in control group（ X^2 = 7.2, 8.9, P 〈 0.01 ）. After 24-week therapy, there were significant difference in normalizalion rate of liver function, HBV DNA and HBeAg seroconversion rate between telbivudine group and control group（ X^2 = 18.7, 12.6, 22.0, P 〈 0.01）, and there were significant differences in these rates between combination group and telbivudine group（ X^2= 4.5, 5.7, 6.1, P 〈 0.01）. Conclusions The short-term effect of telbivudine combined with adefovir dipivoxil in treatment of adefovir dipivoxil-resistant chronic hepatitis B is prominent.
出处
《国际流行病学传染病学杂志》
CAS
2011年第5期301-303,共3页
International Journal of Epidemiology and Infectious Disease
关键词
肝炎
乙型
慢性
早期干预
抗病毒
Hepatitis B, chronic
Early intervention
Anti-virus
