拉米夫定联合阿德福韦酯治疗恩替卡韦初治无应答慢性乙型肝炎1例  

Lamivudine combined with adefovir dipivoxil for treating entecavir-refractory chronic hepatitis B.one case report

作　　者：赵攀[1] 韩玉坤[1] 管群[1] 吴永杰[2] 齐冬颖[1] 

机构地区：[1]解放军第302医院,北京100039 [2]解放军总医院,北京100853

出　　处：《中国感染控制杂志》2011年第4期266-268,共3页Chinese Journal of Infection Control

摘　　要：目的 探讨对恩替卡韦耐药慢性乙型肝炎患者的治疗策略。方法对1例恩替卡韦初治无应答的慢性乙型肝炎患者采取拉米夫定和阿德福韦酯联合应用的治疗策略，并对其病毒学（HBVDNA）和血清学（ALT）指标进行连续追踪和记录。结果经过1年时间的拉米夫定和阿德福韦酯联合抗病毒治疗，该患者的血清HBVDNA载量由换用该治疗策略时的2．（12×10^8IU／mL下降至1．19×10^3IU／mL，血清ALT也恢复至正常水平（≤40U／L）。结论拉米夫定和阿德福韦酯联合应用对该例恩替卡韦耐药的慢性乙型肝炎患者有效，但能否推而广之仍需深入研究。Objective To explore the treatment strategy for entecavir-refractory chronic hepatitis B （CHB） patients. Methods One entecavi-refractory CHB patient was switched to combination treatment of lamivudine with adefovir dipivoxil, and levels of HBV DNA and serum alanine transaminase （ALT） were followed up. Results After one year combined treatment , patient＇ s serum HBV DNA level dropped to 1.19 ×10^3 IU/mL from the initial top of 2. 02 × 10^8 IU/mL and ALT level was recovered to normal range （≤40 U/L）. Conclusion The combination use of lamivudine with adefovir dipivoxil is effective for this entecavir-refractory CHB patient , but whether the treatment can be popularized needs to be further investigated.

关 键 词：肝炎 乙型 慢性 肝炎病毒 乙型 抗病毒治疗 恩替卡韦 拉米夫定 阿德福韦酯 抗药性 微生物 

分 类 号：R512.62[医药卫生—内科学]