替比夫定治疗对阿德福韦酯应答不佳慢性乙型肝炎24个月疗效分析  

Clinical efficacy of telbivudine in the treatment of chronic hepatitis B with poor response to adefovir dipivoxil for 24 months

作　　者：谭淑燕[1] 邹敏超[1] 上官辉[2] 

机构地区：[1]佛山市第二人民医院感染科,广东佛山528000 [2]佛山市第二人民医院血液内科,广东佛山528000

出　　处：《佛山科学技术学院学报（自然科学版）》2014年第4期31-33,共3页Journal of Foshan University(Natural Science Edition)

摘　　要：目的评估应用替比夫定对阿德福韦酯治疗应答不佳慢性乙型肝炎24个月疗效。方法 66例对阿德福韦酯单药治疗应答不佳的HBeAg阳性慢性乙型肝炎患者随机分成2组,A组采用替比夫定(600mg,1次·d-1,口服),单药治疗,B组在原阿德福韦酯治疗(10mg,1次·d-1,口服)的基础上加用替比夫定治疗。治疗期间监测肝功能、HBV标志物、HBV DNA变化情况及耐药情况。观察24个月。结果治疗24个月,A组HBV DNA转阴率为78.8%,HBeAg血清学转换率为21.2%,而B组患者HBV DNA转阴率为97.0%,HBeAg血清学转换率为45.5%。两组比较差异有统计学意义。A组共有4例(12.1%)患者出现耐药,B组为0。无患者因出现严重不良反应而终止抗病毒治疗。结论阿德福韦酯抗病毒治疗应答不佳的HBeAg阳性慢性乙型肝炎患者联合替比夫定进一步治疗具有较好的疗效,而且安全性高,耐药率低。Objective To evaluate the clinical effecacy of telbivudine in the treatment of chronic hepatitis B patients with poor response to adefovir dipivoxil for 24 months. Methods 66 cases of HBeAg-positive chronic hepatitis B patients with poor response to adefovir dipivoxil were randomly divided into two groups. Group A was given telbivudine （600mg·d-1）. Group B was given telbivudine and adefovir dipivoxil （10mg·d-1）. The differences of ALT normaIization rate, HBeAg/HBeAb seroconversion rate and HBV-DNA negative rate between the two groups were compared after 24-month therapy. Results After 24-month therapy, HBV-DNA negative rate and HBeAg/HBeAb seroconversion rate for group A were 78.8%and 21.2%, while those for group B were 97.0%and 45.5%. The indicators of group B were significantIy better than group A. Four cases （12.1%） of group A but none of group B appeared viral resistance. No patient terminated the treatment due to severe adverse event. Conclusion Combination of telbivudine and adefovir dipivoxil has good effect for patients of HBeAg-positive chronic hepatitis B with poor response to adefovir dipivoxil. The treatment is safe and of low viral resistance rate.

关 键 词：肝炎 乙型 慢性 治疗 替比夫定 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]