替诺福韦联合拉米夫定与替诺福韦单药治疗拉米夫定耐药的慢性乙型肝炎抗病毒疗效比较  

Comparison of antiviral efficacy of tenofovir combined with lamivudine versus tenofovir alone in the treatment of lamivudine resistant chronic hepatitis B

作　　者：冯永宝 赵文敬 李花[1] 崔文豪[1] 姜平 韩学吉[1] FENG Yongbao;ZHAO Wenjing;LI Hua;CUI Wenhao;JIANG Ping;HAN Xueji(Affiliated Hospital of Yanbian University,Yanji 133000,Jilin,China)

机构地区：[1]延边大学附属医院,吉林延吉133000

出　　处：《延边大学医学学报》2021年第2期116-119,共4页Journal of Medical Science Yanbian University

摘　　要：[背景]比较替诺福韦(TDF)联合拉米夫定(LAM)与TDF单药治疗LAM耐药的慢性乙型肝炎(CHB)抗病毒的疗效.[病例报告]选择100例LAM耐药的CHB患者,比较TDF单药治疗(n=40)与TDF-LAM联合治疗(n=60)的抗病毒疗效,TDF单药治疗或TDF-LAM联合治疗疗程均为6个月及以上.所有患者均接受过基于TDF的救援治疗,中位时间为30.0个月(8~36个月).99例(96.1%)获得病毒学应答(VR),其中TDF单药治疗组为95.0%(38/40),TDF-LAM联合治疗组为96.7%(58/60).TDF单药治疗组与TDF-LAM联合治疗组VR率间差异无统计学意义(第12月为88.9%比87.3%,第24月为94.4%比93.7%,Log-rank P=0.652).[讨论] TDF单药治疗与TDF-LAM联合治疗同样有效,可在多数LAM耐药的CHB患者中维持病毒抑制.BACKGROUND To compare the antiviral efficacy of tenofovir(TDF) combined with lamivudine(LAM) and TDF monotherapy in the treatment of LAM resistant chronic hepatitis B(CHB). CASE REPORTS A total of 100 CHB patients with LAM resistance were selected, and the antiviral efficacy was compared between TDF monotherapy(n=40) and TDF-LAM combination therapy(n=60). The course of TDF monotherapy and TDF-LAM combination therapy was 6 months or more. All patients had received TDF based rescue treatment, with a median duration of 30 months(8 to 36 months). Virologic response(VR) was achieved in 99 patients(96.1%), including 95.0%(38/40) in the TDF monotherapy group and 96.7%(58/60) in the TDF-LAM combination therapy group. There was no significant difference in VR rate between the TDF monotherapy group and the TDF-LAM combination therapy group(the 12 th month was 88.9% to 87.3%, the 24 th month was 94.4% to 93.7%, Log-rank P=0.652). DISCUSSION TDF monotherapy is equally effective as TDF-LAM combination therapy, and can maintain viral suppression in the majority of CHB patients with LAM resistance.

关 键 词：慢性乙型肝炎 替诺福韦 拉米夫定 耐药 

分 类 号：R512.6[医药卫生—内科学]