阿德福韦酯增量治疗抗HBV应答不佳的疗效研究

Efficacy on increased dose of adefovir dipivoxil to anti-HBV treatment in poor responded patients

目的观察阿德福韦酯(ADV)10mg/d抗HBV治疗应答不佳时,增至15mg/d治疗的疗效和安全性。方法选择45例常规应用ADV 10mg/d且服药1年以上应答不佳的患者,排除ADV耐药及依从性差等因素,将剂量增至15mg/d,观察患者HBV DNA、肝功能、肾功能和心肌酶谱的变化。结果增加ADV剂量后,HBV DNA平均下降了2.5log10拷贝/ml,ALT及AST差异均无统计学意义;11例患者尿素氮(BUN)及肌酐(Cr)升高,但仍在正常范围内;5例患者出现BUN和Cr超出正常范围而停药。结论对于常规应用ADV 10mg/d且抗病毒治疗应答不佳的患者,可增加剂量至15mg/d,其疗效安全可靠。

Objective To observe the efficacy and safety of adefovir dipivoxil （ADV） anti-HBV treatment when the dose increased to 15 mg/d from 10 mg/d when the response is poor. Methods Total of 45 patients were treated with ADV was 10 mg/d conventionally. Factors such as resistance and poor compliance to ADV were excluded, the dose of patients with poor response to ADV 10 mg/d was increased to 15 mg/d and the changes of HBV DNA, liver function, kidney function and myocardial enzymes were observed. Results After the dose was increased by 50%, HBV DNA levels reduced to an average of 2.5 log10 copies/ml, no significant difference was found in ALT and AST. Serum urea nitrogen （BUN） and creatinine （Cr） increased in 11 patients, which were still within the normal range. However, 5 patients discontinued the treatment due to abnormal serum BUN and Cr. Conclusions For patients with poor antiviral response of ADV 10 mg/d, the dose of ADV could increase to 15 mg/d with safe and reliable effect.