核苷(酸)类药物序贯疗法失败后联合用药的比较研究

Comparison combined with Nucleoside/nucleotide Drugs after Sequential Therapy of Failure

目的探讨核苷酸类药物治疗慢性乙型病毒性肝炎序贯疗法失败后,如何联合选择核苷酸类药物抗病毒治疗。方法筛选125例慢性乙型病毒性肝炎患者,在序贯疗法失败后,分为两组,拉米夫定联合阿德福韦酯(A组),恩替卡韦联合阿德福韦酯(B组)进行治疗,以病毒学应答、血清学应答和生化学应答为主要观察指标来评价疗效。结果在慢性乙型肝炎序贯疗法失败后,治疗后B组HBV-DNA水平与A组相比,差异有统计学意义(t=8.012,P<0.01)。B组临床疗效与A组相比,差异有统计学意义(uc=2.36,P<0.01)。结论恩替卡韦联合阿德福韦酯的疗效优于拉米夫定联合阿德福韦酯。

Objective To explore how to select combined with nucleoside/nucleotide drugs after sequential therapy of failure for patients with chronic hepatitis B（CHB）.Methods After failure of sequential therapy,125 CHB were divided into two groups,patients in group A were treated with lamivudine combined with adefovir;patients in group B were treated with entecavir combined with adefovir.The main parameters to evaluate the efficacy were virological,serological response and biochemical responses.Results After failures of equential therapy in CHB,group B was more difference to group A in level down of HBV-DNA after therapy.In the levels of HBV-DNA,the difference was statistically significant between group A and group B after treatment（t=8.012,P0.01）.The clinical efficacy were significiant differences in group A comparing with group B（uc=2.36,P0.01）.Conclusion The effects in the treatment of entecavir combined with adefovir were superior to those in the treatment of lamivudine combined with adefovir.