阿德福韦酯联合苦参素治疗YMDD变异慢性乙型肝炎患者的疗效

Clinical effect of adefovir dipivoxil combined with oxymatrine on patients with chronic hepatitis B with HBV-YMDD mutation

目的:观察阿德福韦酯联合苦参素对经拉米夫定治疗后出现YMDD变异的慢性乙型肝炎患者的疗效和安全性。方法:选择80例慢性乙型肝炎患者,均为拉米夫定治疗过程中出现YMDD变异,HBeAg阳性,肝功能异常者,用阿德福韦酯联合苦参素治疗12个月以上,进行HBV-DNA含量、丙氨酸氨基转移酶(ALT)、HBeAg检测以观察其疗效及安全性。结果:经阿德福韦酯联合苦参素治疗3,6,12个月后HBV-DNA阴转率分别为30.67(17例)、46.83(20例)、61.67(26例),ALT复常率为48.06(20例)、63.71(27例)、80.45(34例)。HBeAg的阴转率为15.83(7例)、27.5(12例)、34.17(14例)。患者服用12个月以上未见明显的肾毒性及耐药变异的情况。结论:阿德福韦酯、苦参素联用可显著提高对YMDD变异的慢性乙型肝炎患者的抗病毒疗效。

OBJECTIVE To study the effect and safety of adefovir dipivoxil combined with oxymatrine on patients with HBV-YMDD mutation after treatment of lamivudine. METHODS Eighty patients with chronic hepatitis B with HBV-YMDD mutation after treatment of lamivudine were chosen. All patients were HBeAg positive, liver function abnormal before this study. All patients with adefovir dipivoxil combined with oxymatrine were treated for more than 12 months. HBV-DNA, Alanine aminotransferase （ALT） and HBeAg were assayed to observe the effect and safety of this therapy. RESULTS After the patients were given adefovir dipivoxil combined with oxymatrine for 3, 6 and 12 months, the negative rate of HBV-DNA were 30. 67%, 46. 83%, and 61.67% ,respectively;the rate of normal level of ALT were 48. 06%,63. 71%,and 80. 45%, respectively; the negative rate of HBeAg were 15. 83%, 27. 5%, 34. 17%, respectively. There was no any significant renal toxicity and drug resistant mutation in patients. CONCLUSION chronic hepatitis B with HBV-YMDD mutation.