恩替卡韦联合拉米夫定治疗慢性乙型肝炎疗效分析  

Effect analysis of lamivudine add-on entecavir in treatment of chronic hepatitis B

作　　者：赵帅[1] 耿玉兰[1] 刘泽世[1] 陈正立[1] 代丽丽[1] 

机构地区：[1]河北医科大学第一医院检验科,河北石家庄050031

出　　处：《中国卫生检验杂志》2014年第4期543-545,共3页Chinese Journal of Health Laboratory Technology

基　　金：河北省卫生厅科研立项(20130565)

摘　　要：目的探讨恩替卡韦联合拉米夫定较单用拉米夫定治疗慢性乙型肝炎的疗效。方法将河北医科大学第一医院156例在治疗前未检测出HBV-YMDD变异并且HBV-DNA均为阳性的慢性乙肝患者随机分为研究组和对照组。其中,研究组采用拉米夫定全程联合恩替卡韦治疗;对照组则单用拉米夫定进行治疗,两组疗程均为12个月。在各组治疗第3个月、第6个月、第9个月、第12个月时分别检测血清HBV-YMDD变异情况与HBV-DNA水平的变化。结果与对照组相比,在第3个月、第6个月、第9个月、第12个月,研究组中患者检出HBV-YMDD变异例数少、HBVDNA阴转率高,两组变异率差别具有统计学意义(P<0.05),两组阴转率差别具有统计学意义(P<0.05)。结论恩替卡韦联合拉米夫定较单用拉米夫定治疗慢性乙型肝炎对患者更安全更有疗效,值得推广应用。Objective To compare the clinical effects of lamivudine add - on entecavir and lamivudine monotherapy on chronic hepatitis B （CHB） patients. Methods One hundred and fifty - six HBV - DNA positive CHB patients without HBV - YMDD mutations were randomly divided into combination therapy group（ treated with lamivudine add - on entecavir） and control group （ lamivudine monotherapy）, and the course of treatment was set at 12 months. During the course, the serum HBV - DNA levels and HBV - YMDD mutation were detected both in combination group and control group on the 3rd, 6th, 9th and 12th month re- spectively. Results The serum HBV - DNA levels and HBV - YMDD mutations decreased, while negative conversion rates of HBV -DNA increased apparently in combination treatment group, when compared with control group on the 3rd, 6th, 9th and 12th month. Both HBV - YMDD mutation rate and HBV - DNA negative conversion rates had statistical difference between the two groups （P 〈 0.05）. Conclusion Lamivudine add - on entecavir combination therapy demonstrated better curative effect on chronic hepatitis B patients than lamivudine monotherapy, worthy of popularization.

关 键 词：慢性乙型肝炎 恩替卡韦 拉米夫定 HBV—YMDD变异 HBV-DNA水平 

分 类 号：R512.62[医药卫生—内科学]