替比夫定联合阿德福韦酯对HBeAg阳性慢性乙型肝炎的疗效观察  

The therapeutic effect of telbivudine plus adefovir dipivoxil on HBeAg positive chronic hepatitis B

作　　者：刘素芬[1] 董正洪[1] 魏娟[1] 冯娜[1] 林琳[1] 吴秀颀[1] 张彦芳[1] 裴艳涛[1] 李兵顺[1] 叶丽红[1] 杨莉[1] 

机构地区：[1]河北省石家庄市第五医院,050021

出　　处：《河北医药》2014年第3期333-335,共3页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题（编号：20120440）

摘　　要：目的探讨替比夫定联合阿德福韦酯对HBeAg阳性慢性乙型肝炎患者的疗效。方法将76例慢性乙型肝炎患者分为干扰素组和替比夫定组,干扰素组应用聚乙二醇干扰素α-2a联合阿德福韦酯,替比夫定组给予替比夫定联合阿德福韦酯,治疗48周,观察血清谷氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)的含量和正常化率及血清HBsAg、HBeAg和乙肝病毒(HBV)DNA的含量及HBeAg阴转率和血清转换率及HBV DNA低于检测下限值率变化。结果 2组治疗后24周和48周ALT和AST的含量及血清HBsAg、HBeAg和HBV DNA的含量均明显降低(P<0.01),而替比夫定组治疗后降低量更显著;ALT和AST正常化率,HBeAg阴转率和血清转换率及HBV DNA低于检测下限值率显著增加(P<0.01),而替比夫定组治疗后的增加量更显著。结论替比夫定联合阿德福韦酯的治疗效果比干扰素联合阿德福韦酯的治疗更加显著。Objective To investigate therapeutic effect of telbivudine plus adefovir dipivoxil on HBeAg positive chronic hepatitis B.Methods Seventy-six patients with chronic hepatitis B were divided into pegylated interferon group （pegylated interferon α-2a） and telbivudine group.The patients in pegylated interferon group were treated by pegylated inter -feron plus adefovir dipivoxil ,however,the patients in telbivudine group were treated by telbivudine plus adefovir dipivoxil ,with a treatment course of48 weeks for both groups.The levels of alanine aminotransferase （ALT）,aspartate aminotransferase （AST） and the levels of HbsAg,HBeAg and HBV DNA in serum were detected before and after treatment in both groups .ALT and AST normalization rate,HBeAg negative conversion rate and seroconversion rate and rate of undetectable HBV DNA were measured too.Results After 24-week and 48-week treatment,the levels of ALT,AST and the levels of HbsAg,HBeAg and HBV DNA were significantly decreased in both groups （ P ＆lt;0.01）,moreover,the decrease degree in telbivudine group was more obvious than that in pegylated interferon group .ALT and AST normalization rate,HBeAg negative conversion rate and seroconversion rate and the rate of undetectable HBV DNA were significantly increased in both groups after 24-week and 48-week treatment （ P ＆lt;0.01）,moreover,the increase degree in telbivudine group was more obvious than that in pegylated interferon group.Conclusion The therapeutic effect of telbivudine plus adefovir dipivoxil is superior to that of pegylated interferon α-2a plus adefovir dipivoxil in the treatment of chronic hepatitis B .

关 键 词：慢性乙型肝炎 替比夫定 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]