摘要
目的评价阿德福韦(ADV)和恩替卡韦(ETV)治疗慢性乙型肝炎HBV YMDD变异患者144周的疗效和安全性。方法 2005年6月至2007年6月在门诊和住院的经拉米夫定(LAM)治疗后出现HBV YMDD变异的慢性乙型肝炎患者120例,随机分为4组,A组单用ADV 10mg/d治疗144周;B组采用ADV 10mg/d和LAM 100 mg/d联合治疗12周,后单用ADV 10mg/d治疗132周;C组采用ADV 10 mg/d和LAM 100 mg/d联合治疗144周;D组接受ETV1 mg/d治疗144周。结果治疗144周时四组患者HBeAg血清转换率比较,差异均无统计学意义(P>0.05)。C组患者ALT复常率、HBV DNA达到检测水平以下的百分率与A组、B组、D组比较,差异均有统计学意义(P<0.05);四组患者144周的基因型耐药率分别为30%(9/30)、26.7%(8/30)、3.3%(1/30)、40%(12/30)(x^2=11.556,P<0.05)。结论慢性乙型肝炎患者发生HBV YMDD变异后采用ADV与LAM联合治疗更安全有效。
Objective To evaluate the efficacy and safety of adefovir dipivoxil or in combination with lamivudine and entecavir in the treatment of chronic hepatitis B with YMDD mutation. Methods A total of 120 chronic hepatitis B patients with YMDD mutation were randomly assigned into four groups. In A group, patients received adefovir dipivoxil for 144 weeks. In group B, patients received adefovir dipivoxil in combination with lamivudine during the first 12 weeks and adefovir dipivoxil only for the following 132 weeks. In group C, patients received adefovir dipivoxil in combination with lamivudine for 144 weeks. In group D, patients received entecavir（1 rag） for 144 weeks. Results There was no significant difference in the rate of HBeAg seroconversion after 144-week （P ~ 0. 05）. At 144th week, there was significant difference in the ALT normalization rate and undetectable HBV DNA rate among group C and group A,B and D（P〈0.05）, and the rate of drug resistant genotype was 300//00（9/30）, 26.70/00（8/30）, 3.3%（1/30） and 40%（12/ 30） （P〈0.05）. Conclusion Adefovir dipivoxil in combination with LAM is the safe and effective option for chronic hepatitis B patients with YMDD mutation.
出处
《肝脏》
2011年第5期370-372,共3页
Chinese Hepatology
基金
江苏省无锡市卫生系统指令性科研项目(XM0704)
