阿德福韦酯联合拉米夫定治疗耐药性HBeAg阴性慢性乙型肝炎  

Adefovir Dipivoxil Combined with Lamivudine to Treat Lamivudine-resistant HBeAg-negative Chronic Hepatitis B

作　　者：万十千 石涵[2] 万学发[2] 彭建新 

机构地区：[1]武汉医疗救治中心肝科,湖北武汉430023 [2]台州中心医院肝科,浙江台州318000 [3]武汉市江夏区人民医院急诊科,湖北武汉430020

出　　处：《中华医院感染学杂志》2010年第16期2502-2503,共2页Chinese Journal of Nosocomiology

摘　　要：目的观察阿德福韦酯联合拉米夫定治疗耐药HBeAg阴性慢性乙型肝炎YMDD变异的临床疗效。方法拉米夫定耐药HBeAg阴性慢乙型肝炎患者60例分A组30例、B组30例,动态观察患者血清HBVDNA、HBeAg、HBeAb和肝功能变化。结果 A组HBVDNA阴转率在12、24、48、72周时分别为30.0%、43.3%、50.0%、76.7%,B组分别为26.7%、33.3%、40.0%、46.7%,但两组之间比较在72周时差异有统计学意义(χ2=2.855,P<0.05);A、B两组ALT复常率比较在12周时A组明显高于B组,差异有统计学意义(χ2=2.703,P<0.05)。结论阿德福韦酯单独或联合拉米夫定,对拉米夫定耐药的HBeAg阴性慢性乙型肝炎均有治疗作用;联合用药效果更好。OBJECTIVE To observe the therapeutic effect of adefovir dipivoxil combination with lamivudine in the treatment of lamivudine-resistant HBeAg-negative chronical hepatitis B（YMDD mutant）.METHODS A total of 60 patients with lamivudine-resistant HBeAg-negative chronic hepatitis B were divided into two groups：A with combination therepy and,B with monotherapy,with 30 cases in each group.Changes in serum HBV DNA,and liver functions were dynamically monitored.RESULTS At the end of the 12th,24th,48th and 72nd week of treatment,the rates of sera to turn negative for HBV DNA were 30.0%,43.3%,50.0% and 76.7%,respectively in patients of group A,and 26.7%,33.3%,40.0% and 46.7%,respectively in patients of group B.The difference between the two groups was statistically significant （χ2=2.855,P0.05） only at 72nd week.At the end of the 12th week,the rate for serum ALT in patients of group A was significantly higher than that of group B,the difference was statistically significant （χ2=2.703,P0.05）.CONCLUSION Both combination therapy and monotherapy have a good response to lamivudine-resistant HBeAg-negative chronical hepatitis B,but drug combination can achieve better therapeutic effects.

关 键 词：阿德福韦酯 拉米夫定 HBEAG阴性 慢性乙型肝炎 抗药性 变异 

分 类 号：R978.1[医药卫生—药品]