拉米夫定应用史对恩替卡韦单用治疗耐阿德福韦的慢性乙型肝炎患者疗效的影响

Influence of using lamivudine on therapeutic efficacy of entecavir in chronic hepatitis B patients on adefovir therapy

目的系统评价拉米夫定应用史对恩替卡韦单用治疗耐阿德福韦的慢性乙型肝炎患者疗效影响。方法检索2010年5月以前发表的有关恩替卡韦单用(剂量1mg/d、疗程≥12周)对耐阿德福韦的慢性乙型肝炎患者疗效(以有无拉米夫定用药史为分组标准,以血清HBV DNA水平为观察指标)的中外文献,应用Meta分析方法,以相对危险度为疗效分析统计量进行合并分析。结果最终纳入2篇英文文献,平均效应尺度约为0.52,其95%置信区间为0.29-0.93。结论有拉米夫定用药史会使恩替卡韦单用治疗对耐阿德福韦的慢性乙型肝炎患者的疗效下降。

Objective To evaluate the influence of using lamivudine on therapeutic efficacy of entecavir monotherapy in chronic hepatitis B patients on adefovir therapy.Methods Papers in Chinese and English（published before May,2010） on the therapeutic efficacy of entecavir monotherapy in chronic hepatitis B patients on adefovir therapy were searched.A meta-analysis was performed for the papers that were divided into different groups according to the history of using lamivudine and the serum HBV DNA level,with the relative risk calculated as the therapeutic efficacy.Results Only 2 English papers were included.The average relative risk was 0.52 and the confidence interval was 0.29-0.93.Conclusion The history of using lamivudine reduces the therapeutic efficacy of entecavir monotherapy in chronic hepatitis B patients on adefovir therapy.