阿德福韦酯片治疗e抗原阳性慢性乙型肝炎临床观察  

Clinical observation on effect of adefovir dipivoxil in treating chronic hepatitis B with e antigen-positive

作　　者：孔庆芬[1] 严晓会[1] 缪新权[1] 杨艳霞[1] 

机构地区：[1]玉溪巿人民医院感染科,云南玉溪653100

出　　处：《现代医药卫生》2012年第4期516-517,共2页Journal of Modern Medicine & Health

摘　　要：目的评价国产阿德福韦酯片治疗乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎患者的安全性与效果。方法125例HBeAg阳性慢性乙型肝炎患者随机分为治疗组65例,口服阿德福韦酯片治疗;对照组60例,用α干扰素-2b治疗。两组治疗开始后,每4个月检查肝功能、肾功能、乙型肝炎病毒(HBV)标志物、HBV DNA定量等指标。24个月治疗期间和治疗后,比较两组血清HBV DNA阴转率、丙氨酸氨基转移酶(ALT)复常率、HBeAg阴转率、HBeAg/抗-HBe血清转换率和不良反应。结果治疗组患者治疗后6、12、18、24个月,HBeAg阴转率分别为12.3%、23.1%、41.5%和60.0%;HBV DNA阴转率分别为0%、13.8%、27.7%和43.1%;HBeAg/抗-HBe血清转换率分别为9.2%、16.9%、23.3%和50.8%,HBeAg阴转率、HBV DNA阴转率、HBeAg/抗-HBe血清转换率均随治疗时间延长而升高,且与对照组不同时期各项指标(治疗6、12个月HBV DNA阴转率除外)比较,差异均有统计学意义(P<0.05或P<0.01)。治疗组患者治疗24个月后ALT复常率为66.1%,治疗期间无不良反应发生。结论国产阿德福韦酯片治疗慢性乙型肝炎安全性与有效性较好,疗程延长疗效好。Objective To evaluate the safety and efficacy of domestic adefovir dipivoxil in the treatment of chronic hepatitis B（CHB） with e antigen-positive.Methods 125 CHB patients with HBeAg-positive were randomly divided into the treatment group and the control group.The treatment group（65 cases） received oral adefovir dipivoxil.The control group was treated by α-interferon-2b.After the beginning of treatment,the liver function,renal function,HBV markers and quantitative HBV DNA were detected every 4 months.During 24-month treatment course and after treatment,the rates of serum HBV-DNA negative-conversion,alanine aminotransferase（ALT） renormalization rate,HBeAg negative-conversion rate,anti-HBe positive-conversion rate,Cr and adverse reactions were compared between the two groups.Results After 6,12,18,24 months of treatment,the rates of HBeAg negative-conversion,HBV-DNA negative-conversion and HBeAg/Anti-HBe seroconversion rate were 12.3%,0%,9.2%;23.1%,13.8%,16.9%;41.5%,27.7%,23.3% and 60.0%,43.1% and 50.8% respectively,showing statistical differences among various indexes.Conclusion Domestic adefovir dipivoxil for treating CHB is safe and effective with prolonged treatment course.

关 键 词：肝炎e抗原 乙型 肝炎 乙型 慢性 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]