拉米夫定联合阿德福韦酯治疗HBeAg阳性慢性乙型肝炎疗效分析  

Effects of lamivudine plus adefovir dipivoxil on HBeAg-positive chronic hepatitis B:analyses of 110 cases

作　　者：刁蔚欣[1] 张少华[1] 杨小蓉[1] 梁丽坤[1] 

机构地区：[1]广东药学院附属第一医院感染科,广东广州510082

出　　处：《广州医学院学报》2014年第2期79-81,共3页Academic Journal of Guangzhou Medical College

基　　金：广东省医学科研基金(A2012314)

摘　　要：目的:观察拉米夫定联合阿德福韦酯治疗慢性乙型肝炎患者的临床疗效及安全性。方法:选取2008年1月到2011年12月收治的HBeAg阳性慢性乙型肝炎患者110例,分组为单药组和联合组,单药组服用拉米夫定100 mg/d,联合组服用拉米夫定100 mg/d和阿德福韦酯10 mg/d,观察两组患者治疗96周的疗效及不良反应。结果:治疗96周后,联合组的HBV-DNA应答率、ALT复常率、HBeAg阴转率、HBeAg血清学转换率分别为96.4%、94.5%、61.8%和41.9%,远高于单药组的72.7%、83.7%、45.3%和34.5%(P<0.05),两组治疗期间仅见轻度不良反应。单药组出现12例病毒学突破,联合组未见。结论:HBeAg阳性的慢性乙型肝炎患者,使用拉米夫定联合阿德福韦酯治疗可以提高临床疗效,降低病毒耐药率,具有良好的安全性。Objective:To investigate the efficacy and safety of lamivudine(LAM) plus adefovir dipivoxil(ADV) on HBeAg-positive chronic hepatitis B(CHB).Methods:Between January 2008 and December 2011,we recruited 110 patients with chronic hepatitis B who were assigned to receive LAM lOOmg/d alone(monotherapy group) or in combination with ADV 10mg/d(treatment group) for 96 weeks.This was followed by assessment of the efficacy and adverse reaction at week 96.Results:After 96-week treatment,the combination treatment group yielded markedly higher responsiveness rate of HBV DNA(96.4%vs 72.7%),the recovery rate of ALT(94.5%vs 83.7%),the negativity of HBeAg(61.8%vs 45.3%) and the seroconversion rate of HBeAg(41.9%vs 34.5%)(all P<0.05).Only mild adverse reactions were found.There were 12 cases with virological breakthrough in the monotherapy group and nil case in the combination treatment group.Conclusion:The combination of LAM and ADV markedly increases the efficacy and reduces the resistant rate and is associated with high safety profiles in patients with HBeAg-positive chronic hepatitis B.

关 键 词：拉米夫定 阿德福韦酯 HBEAG阳性慢性乙型肝炎 

分 类 号：R512.6+2[医药卫生—内科学]