拉米夫定联合腺嘌呤核苷类似物治疗慢性乙型肝炎临床对照研究

目的核苷类似物联合干扰素治疗慢性乙型肝炎临床对照研究。方法慢性乙型肝炎患者180例,随机分为A、B、C组,每组60例。A组采用拉米夫定联合腺嘌呤核苷类似物治疗,B组采用拉米夫定治疗,C组采用阿德福韦酯治疗,观察各组患者治疗第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2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2组,差异有统计学意义(P<0.05)。结论拉米夫定与腺嘌呤核苷类似物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 nucleoside analogues combined with interferon treatment of chronic hepatitis B control study.Methods 180 patients with chronic hepatitis B were randomly divided into A,B,C group,60 cases each.A group of adenine nucleoside analogues with lamivudine therapy,B with lamivudine in the treatment group,C group received adefovir dipivoxil treatment,patients in each group during the first week of HBV-12、24、48 DNA and HBeAg negative rate,ALT normalization rate,HBeAg/anti-HBe seroconversion rate changes.Results HBV-DNA negative conversion rate of A group of three time points than the other two groups,B group than C group at week 24,the difference was statistically significant（P0.05 or P0.01）.A group rate of ALT normalization at 12 weeks and 48 weeks better than the C group,48 weeks is better than B group,B group than C group at 12 weeks,the difference was statistically significant（P0.05 or P0.01）.HBeAg seroconversion rate of 48 weeks,group A is better than the other two groups,the difference was statistically significant（P0.05）.Conclusion adenine nucleoside analogues lamivudine and adefovir dipivoxil combination therapy more effective than individual with lamivudine or adefovir dipivoxil.