拉米夫定联合阿德福韦酯治疗慢性乙型肝炎疗效观察

Clinical efficacy of Lamivudine and Adefovir in the treatment of patients with chronic hepatitis B

目的:探讨拉米夫定联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法:慢性乙型肝炎患者90例,随机分为A、B、C三组,每组30例。A组采用拉米夫定联合阿德福韦酯治疗,B组采用拉米夫定治疗,C组采用阿德福韦酯治疗,观察三组患者治疗第12、24、48周时HBV-DNA和HBeAg转阴率、ALT复常率、HBeAg/抗-HBe血清转换率变化情况。结果:HBV-DNA转阴率A组3个时间点优于另外两组,B组第24周优于C组,差异有统计学意义(P<0.05或P<0.01)。ALT复常率A组第12周和第48周优于C组,第48周优于B组,B组第12周优于C组,差异有统计学意义(P<0.05或P<0.01)。HBeAg转阴率第48周A组优于另外两组,差异有统计学意义(P<0.05)。HBeAg/抗-HBe血清转换率A组最高,但三组比较,差异无统计学意义(P>0.05)。结论:拉米夫定与阿德福韦酯联合用药疗效优于单独使用拉米夫定或阿德福韦酯。

Objective： To investigate the clinical efficacy of Lamivudine and Adefovir in the treatment of patients with chronic hepatitis B. Methods： 90 patients with chronic hepatitis B were randomly divided into three groups, group A, B and C, with 30 patients in each group. Group A was treated with Lamivudine and Adefovir, group B was treated with Lamivudine and group C was treated with Adefovir. The changes of negative rate of HBV-DNA, HbeAg and ALT, the frequency of scroconversion of HBeAg/anti-HBe among the three groups at twelfth week, twenty-fourth week and forty-eighth week after treatment were observed. Results： The negative rates of HBV-DNA in group A at all the three time points were higher than the other two groups, group B was higher than group C at twenty-fourth week, and showed a significant difference （P〈0.05 or P〈0.01）. The negative rate of ALT in group A was higher than group C at twelfth week and forty-eighth week, better than group B at the forty-eighth week, group B was higher than group C at twelfth week, and showed a significant difference （P〈0.05 or P〈0.01）. The negative rate of HBeAg in group A was higher than the other two groups at forty-eighth week, and showed a significant difference （P〈0.05）. The frequency of seroconversion of HBeAg/anti-HBe in group A was the highest, but it showed no significant difference （P〉0.05）. Conclusion： Combination of Lamivudine and Adefovir in the treatment of chronic hepatitis B has advantage over Lamivudine or Adefovir treatment alone.