拉米夫定联合阿德福韦酯初始治疗慢性乙型肝炎患者临床观察

Clinical study on antiviral efficacy of de novo lamivudine and adefovir dipivoxil treatment in patients with chronic hepatitis B

目的探讨拉米夫定联合阿德福韦酯初始慢性乙型肝炎的临床疗效。方法将120例慢性乙型肝炎初始患者随机分为两组,分别给予拉米夫定联合阿德福韦酯治疗或拉米夫定单药治疗24周后,对HBV DNA未阴转者再加用阿德福韦酯治疗,观察48周。结果两组HBV DNA总体阴转率无显著性差异(P>0.05);对于HBVDNA≥107copies/ml患者,两组HBV DNA阴转率于第4和16周差异无显著性(P>0.05),但在第24周(x2=4.573,P<0.05)和第48周差异具有显著性(x2=4.289,P<0.05)。结论对于高病毒载量的慢性乙型肝炎患者宜选用联合方案进行抗病毒初始治疗,以期达到更好的疗效。

Objective To analyze the clinical effect of lamivudine（LAM）in initial combination with adefovir dipivoxil（ADV）in treatment of patients with chronic hepatitis B（CHB）.Methods One hundred and twenty CHB patients were randomly divided into two groups.The patients in one group（n=60）were subjected to treatment with LAM alone for 24 weeks and when HBV DNA were not negative,the patients were switched to combination of LAM and adefovir dipivoxil（ADV）subsequently,while the patients in other group（n=60）were given LAM in combination with ADV de novo.Results The rates of serum HBV DNA loss in the two groups were not significantly different（P〉0.05）,and the rates of serum HBV DNA in patients with HBV DNA≥107copies/ml at week 4 and 16 were not significantly different（P〉0.05）,but at week 24（x^2=4.573,P〉0.05）and week 48 were significantly different（x^2=4.289,P〈0.05）.Conclusions Patients with high serum viral load should be treated by initial combination therapy in order to achieve better results.