摘要
目的探讨富马酸替诺福韦酯(TDF)单药长期治疗多药耐药慢性乙型肝炎(CHB)的临床疗效及安全性。方法选取2008年12月—2012年12月收治的多药耐药CHB 128例,根据治疗方法分为观察组60例和对照组68例,对照组在常规治疗基础上予以TDF联合恩替卡韦(ETV)治疗,观察组在常规治疗基础上仅给予TDF单药治疗,2组均治疗144周。分别于治疗48周和144周记录并比较2组肝功能及血清病毒学相关指标检查结果及临床疗效,并记录2组在治疗过程中相关不良反应的发生情况。结果 2组治疗后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)和乙型肝炎病毒(HBV)DNA水平均较治疗前下降,且治疗144周后下降程度大于治疗48周时(P<0.05),但2组同时间段比较差异无统计学意义(P>0.05)。2组治疗144周时其HBe Ag转阴、ALT复常及临床有效率均高于治疗48周(P<0.05),但2组同时间段比较差异无统计学意义(P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 TDF单药治疗多药耐药CHB效果较好,且安全性较高。
Objective To investigate clinical efficacy and safety of Tenofovir Disoproxil Fumarate （TDF） monotherapy in long-term treatment of patients with Muhidrug Resistance chronic hepatitis B （ CHB）. Methods A total of 128 Muhidrug Resistance resistant CHB patients admitted during December 2008 and December 2012 were divided into observation group （ u = 60） and control group （ u = 68） according to therapeutic methods. Control group was treated with TDF combined with Entecavir （ETV） on the basis routine treatment for CHB, while observation group was treated with TDF monotherapy on the basis routine treatment for CHB. All patients were treated for 144 weeks. After treatment for 48 weeks and 144 weeks, liver function, results of serum virology-related indexes and clinical effect were compared, and incidence rates of adverse reactions were recorded in two groups. Results After treatment, levels of alanine transarninase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL） and hepatitis b virus （HBV） DNA were significantly lower than those before treatment in two groups, and decreased degrees after treatment for 144 weeks were significantly greater than those after treatment for 48 weeks （P 〈 0.05 ） , but there were no significant differences in the same time between two groups （P 〉 0.05 ）. Values of HBeAg negative conversion, ALT normalization and clinical effective rate after treatment for 144 weeks were significantly higher than those after treatment for 48 weeks in two groups （P 〈 0.05 ） , but there were no significant differences in the same time between two groups （ P 〉 0.05 ）. There was no significant difference in incidence rate of adverse reactions between two groups （ P 〉 0.05 ）. Conclusion TDF monotherapy in long-term treatment of patients with Muhidrug Resistance CHB has good clinical efficacy and safety.
作者
刘洁
漆俊
胥富波
LIU Jie;QI Jun;XU Fu-bo(Department of Loemology,the First People＇s Hospital of Liangshan,Xichang,Sichuan 615000,China)
出处
《解放军医药杂志》
CAS
2018年第7期64-67,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
四川省自然科学基金项目(8BF3524)
关键词
乙型肝炎
慢性
富马酸替诺福韦酯
多药耐药
临床疗效
安全性
Hepatitis B
chronic
Tenofovir disoproxil fumarate
Muhidrug resistance
Clinical efficacy
Safety
