临床肝胆病杂志Issue(7)：636-638,3.DOI:10.3969/j.issn.1001-5256.2014.07.015
拉米夫定耐药慢性乙型肝炎患者改用或加用阿德福韦酯治疗48周疗效比较
Forty-eight-week efficacy of adefovir dipivoxil alone versus combined with lamivudine in treatment of lamivudine-resistant HBeAg-positive chronic hepatitis B
黄美金 1覃后继 1何延专 1黄其文 1周耀南 1丘海先1
作者信息
- 1. 百色市右江民族医学院附属医院 感染性疾病科，广西 百色533000
- 折叠
摘要
Abstract
Objective To observe the therapeutic efficacy and safety of adefovir dipivoxil (ADV)alone versus combined with lamivudine (LAM)in the treatment of LAM-resistant HBeAg-positive chronic hepatitis B (CHB).Methods Forty patients with LAM-resistant HBeAg-positive CHB were randomly assigned to monotherapy group (n=20)and combination therapy group (n=20).The monotherapy group received ADV alone,while the combination therapy group received ADV combined with LAM.After 24 and 48 weeks of treatment,se-rum HBV DNA level,undetectable HBV DNA rate,HBeAg loss rate,alanine aminotransferase (ALT)normalization rate,adverse reac-tions,and drug resistance were assessed.The two groups were compared by t-test for continuous data and chi-square test for categorical data.Results There were no significant differences in sex,age,and pretreatment levels of serum HBV DNA and ALT between the two groups (P>0.05).After 48 weeks of treatment,serum undetectable HBV DNA rate and ALT normalization rate for the combination therapy group were 90%and 95%,respectively,significantly higher than those for the monotherapy group (60%and 65%)(P<0.05);there was no significant difference in HBeAg loss rate between the combination therapy group and monotherapy group (45%vs 35%,χ2 =0.417,P=0.519).Conclusion ADV alone or combined with LAMhas good clinical efficacy in the treatment of LAM-resistant HBeAg-positive CHB.However,the combination therapy can increase undetectable HBV DNA rate and ALT normalization rate and has good safety,and it holds promise for clinical application.关键词
肝炎,乙型,慢性/拉米夫定/阿德福韦酯/抗药性,病毒Key words
hepatitis B,chronic/lamivudine/adefovir dipivoxil/drug resistance,viral分类
医药卫生引用本文复制引用
黄美金,覃后继,何延专,黄其文,周耀南,丘海先..拉米夫定耐药慢性乙型肝炎患者改用或加用阿德福韦酯治疗48周疗效比较[J].临床肝胆病杂志,2014,(7):636-638,3.
