阿德福韦酯对耐拉米夫定乙型肝炎患者疗效的临床研究  

Clinical observation about adefovir in treatment of lamivudine-resistant patients with chronic hepatitis B

作　　者：张伟红[1] 钟水清[1] 

机构地区：[1]浙江省松阳县人民医院感染科,浙江松阳县323400

出　　处：《中华医院感染学杂志》2011年第21期4576-4577,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨耐拉米夫定慢性乙型肝炎的治疗方法,以积累经验,指导临床工作。方法收集医院住院治疗的120例对拉米夫定耐药的慢性乙型肝炎患者,依随机的原则分为观察组与对照组,观察组60例,应用阿德福韦酯和拉米夫定治疗,对照组60例单纯应用阿德福韦酯治疗,分析2种治疗方法对拉米夫定耐药的慢性乙型肝炎的疗效,并观察治疗前后血清中TNF-α的变化。结果观察组治疗9个月及12个月HBV-DNA转阴率为63.33%、76.67%,明显高于对照组的45.00%、53.33%,观察组治疗12个月后血清中TNF-α的下降值为(62.38±8.60)ng/L,明显高于对照组的(46.44±7.06)ng/L。结论阿德福韦酯联合拉米夫定治疗耐拉米夫定慢性乙型肝炎,临床效果明显,并能有效调节血清中TNF-α的含量,从机体微环境角度调节治疗。OBJECTIVE To investigate the treatment methods of lamivudine-resistant patients with chronic hepatitis B, for accumulating clinical experience and directing the clinical work. METHODS 124 cases with chronic hepatitis were divided into two groups randomly. The observation group （62 cases） was treated by adefovir laminvudine. The control group （62 cases） was treated by adefovir. The clinical effect and TNF-a change were observed in the two group. RESULTS The negative-changing rate were better in the 9 months and 12 months in the observation group （63.33%, 76. 67%） than in the control group（45.00%, 53.33%）. The decreased value of TNF-a were higher in the observation group（62.38 ± 8.60ng/L） than in the control group（46.44± 7.06 ng/L）. CONCLUSION Treatment of adefovir and lamivudine is better, can decrease the expression of TNF-a in lamivudine-resistant patients with chronic hepatitis B. The treatment methods is worthy of being recommended in clinical treatment.

关 键 词：阿德福韦酯 拉米夫定 慢性乙型肝炎 TNF-Α 临床观察 治疗 

分 类 号：R978.1[医药卫生—药品]