摘要
目的研究恩替卡韦联合阿德福韦酯对拉米夫定耐药的慢性乙型肝炎患者的疗效和安全性。方法选取2011年1月—2013年1月在邯郸市传染病医院就诊的对拉米夫定耐药的慢性乙型肝炎(chronic hepatitis B,CHB)患者160例作为研究对象,将其分为两组:恩替卡韦联合阿德福韦酯组(A组,80例)和拉米夫定联合阿德福韦酯组(B组,80例)。完成12周、24周、48周治疗时,检测HBVDNA、ALT、HBe Ag、HBs Ag、肾功能、血常规及超声。结果治疗第12、24、48周时,HBVDNA<500 IU/ml的患者,A组分别占55.00%、75.00%、80.00%,B组分别占26.25%、42.50%、45.00%,组间各数据比较,差异具有统计学意义(P<0.001);ALT复常率A组分别占65.00%、85.00%、90.00%,B组分别占37.50%、57.50%、62.50%,组间各数据比较,差异具有统计学意义(P<0.001);两组HBe Ag血清学转阴率和血清转换率对比,差异无统计学意义(P>0.05),均无HBs Ag转阴。两组均无严重不良反应。结论恩替卡韦联合阿德福韦酯治疗拉米夫定耐药的慢性乙型肝炎患者,可在病毒学及生化学方面取得较好的疗效。
Objective To evaluate the effcacy of the combined therapy with entecavir （ETV）and adefovir dipivoxil （ADV）in patients with lamivudine （LAM）-resistant chronic hepatitis B （CHB）. Methods A total of 160 patients who were diagnosed with LAM-resistant CHB admitted to the infectious disease hospital in Handan from January 2011 to January 2013 were selected as the study objects and they were divided to two groups Entecavir combined with adefovir dipivoxil group （group A, 80 cases） and lamivudine combined with adefovir dipivoxil group （group B, 80 cases）. After 12 weeks, 24 weeks and 48 weeks, HBVDNA, ALT, HBeAg, HBsAg, renal function, blood routine and ultrasound were detected. Results At 12, 24, 48 weeks of treatment, patients with HBVDNA 〈 500 IU/ml, A group accounted for 55.00%, 75.00%, 80.00%, respectively. Group B accounted for 26.25%, 42.50%, 45.00% respectively. The difference between groups was statistically signifcant （P 〈 0.001）. The ALT repetition rate A group accounted for 65.00%, 85.00% and 90.00% respectively. Group B accounted for 37.50%, 57.50%, 62.50% respectively. The difference between groups was statistically signifcant （P 〈 0.001）. There was no signifcant difference in the serological negative rate and seroconversion rate between the two groups （P 〉 0.05）, and there was no HBsAg negative in the HBeAg group. There was no serious adverse reaction in all two groups. Conclusion Entecavir combined with adefovir dipivoxil in the treatment of lamivudine resistant chronic hepatitis B patients can achieve better effcacy in virology and biochemistry.
作者
孔洪彬
KONG Hongbin(No.7 Hepatology Department,Handan City Infectious Diseases Hospital,Handan Hebei 056002,Chin)
出处
《中国继续医学教育》
2018年第22期111-112,共2页
China Continuing Medical Education
基金
河北省邯郸市科学技术研究与发展计划项目(1123108080-16)
关键词
恩替卡韦
阿德福韦酯
拉米夫定
联合治疗
耐药
疗效
entecavir
adefovir
lamivudine
combination therapy
resistant
clinical effcacy
