拉米夫定联合阿德福韦酯治疗慢性乙型肝炎疗效观察

The Efficacy Observation of Lamivudine Combined with Adefovir Dipivoxil in Treatment of Chronic Hepatitis B

目的:观察拉米夫定联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法:选取我院自2008年2月至2011年3月收治的慢性乙型肝炎患者52例,随机分为对照组和观察组,每组26例。对照组单独采用拉米夫定给药12个月,观察组使用拉米夫定与阿德福韦酯联合给药12个月,观察两组患者治疗后肝功能指标中ALT的变化、HBV DNA血清变化、HBV血清学标志、病毒变异情况及不良反应。结果:两组患者治疗后ALT、血清HBV DNA水平均低于治疗前(P<0.05),观察组上述指标均明显低于对照组(P<0.05);观察组患者的血清HBV DNA与HBeAg阴转率、转换率均显著高于对照组(P<0.05);两组患者用药后均未出现病毒变异情况及严重的不良反应。结论:拉米夫定联合阿德福韦酯治疗慢性乙型肝炎能有效抑制病毒复制,临床疗效显著,无严重不良反应,适宜临床广泛应用。

Objective： To observe the clinical efficacy of lamivudine combined with adefovir dipivoxil to treat with chronic hepatitis B. Method： 52 cases with chronic hepatitis B were selected from Feb. 2008 to Mar. 2011 in our hospital, They were randomly divided into control group and observation group, and 26 ca- ses in each group. The control group was given lamivudine for 12 months while the observation group was given lamivudine combined adefovir dipivoxil 12 months, then observed the ALT, HBV DNA changes in serum, HBV serological markers, viral variation and adverse reactions after the treatment. Result： The ALT, serum HBV DNA levels of post-treatment were lower than which of the pre-treatment （ P〈0.05 ） and the above index was lower than the control group （ P〈0. 05 ） ; The serum HBV DNA and negative transfer rate, conversion rate in the observation group were significantly higher than those in the control group （ P〈0.05 ） ; There were no variations in the virus and severe adverse reactions. Conclusion： Lamivudine combined adefovir dipivoxil in treatment chronic hepatitis B can effectively suppress viral replication; the clinical effect is significant, there＇s no serious adverse reactions, it＇s suitable for clinical spreading.