慢性乙型病毒性肝炎选用不同抗病毒药物临床疗效观察

Efficiency of different antiviral drugs treatment for chronic viral hepatitis B

目的临床观察拉米夫定和阿德福韦酯及干扰素治疗慢性乙型病毒性肝炎的疗效及不良反应。方法随机应用单一抗病毒口服药拉米夫定治疗24个月患者43例、应用阿德福韦酯治疗24个月患者41例,联合应用阿德福韦酯及干扰素-α患者36例。分别记录并对比三组患者治疗6个月、12个月、18个月、24个月时疗效及不良反应。结果三组病例在治疗各时段肝功能明显改善、血HBV-DNA水平大幅下降、乙肝标志物的阴转率增高。病毒变异发生率以拉米夫定治疗组最高(P<0.01)。联合治疗组在肝功能改善、血HBV-DNA水平降低、乙肝标志物的阴转率等各方面均优于前两组单一口服用药组,差异显著(P<0.01)。结论阿德福韦酯保护肝功能、抑制病毒复制效果良好而不易发生病毒变异。与干扰素联合使用,安全有效,明显提高乙肝标志物的阴转率和治疗成功率。

Objective To observe the efficiency and adverse reactions of different antiviral drugs treatment for chronic viral hepatitis B. Methods Oral drug was used to treat patients for 24 months randomly,lamivudine 43 cases and adefovir dipivoxil 41 cases.Thirty-six cases were treated with Adefovir dipivoxil combined with interferon.The efficiency and adverse reactions of three groups in 6 months,12 months,18 months and 24 months were recorded and contrasted. Results In three groups,liver functions were improved,quantity of blood HBV-DNA significantly decreased,the ratio of serum markers negative transformation increased.The incidence of virus variation was the highest in lamivudine group（P〈0.01）.Improvement of liver functions,decreased of quantity of blood HBV-DNA,the ratio of serum markers negative transformation in adefovir dipivoxil combined with interferon group were better than two other single drug groups（P〈0.01）. Conclusion Adefovir dipivoxil can protect liver functions,restrain virus replication,and the virus mutates don＇t happen easily.Adefovir dipivoxil combined with interferon treatment for chronic viral hepatitis B is very safe and effective.