阿德福韦酯胶囊对HBeAg阳性初治慢性乙肝患者疗效观察

Efficacy observation of adefovir dipivoxil capsule for HBeAg-positive patients with chronic hepatitis B

目的观察阿德福韦酯胶囊治疗初治HBeAg阳性慢性乙肝患者的临床疗效及不良反应。方法选择HBeAg阳性初治慢性乙肝患者89例,给予阿德福韦酯胶囊口服治疗,观察3、6、9、12、15、18个月的HBV-DNA阴转率、HBeAg阴转率、HBeAg血清转换率、血清谷丙转氨酶(ALT)复常率、应答情况及不良反应。结果患者HBV-DNA阴转率和HBeAg阴转率治疗6个月时均显著升高,6个月后仍继续上升,但趋于平稳。HBeAg血清转换率治疗3个月时为0.00%,6、9个月时显著升高,9个月后仍继续上升,但趋于平稳。所有患者ALT均于9个月时复常。所有患者18个月时未完全应答率为34.83%,完全应答率为11.24%,总应答率为46.07%。9例患者出现肾功能异常,但未再进一步恶化,此外未发现严重不良反应及并发症。结论阿德福韦酯胶囊治疗初治HBeAg阳性慢性乙肝患者疗效显著,且相对安全可靠,其肾毒性值得关注。

Objective To observe the clinical efficacy and adverse reactions of adefovir dipivoxil capsule for HBeAg-positive patients with chronic hepatitis B.Methods Eighty-nine HBeAg-positive patients with chronic hepatitis B received adefovir dipivoxil capsule.The HBV-DNA negative conversion rate,HBeAg negative conversion rate,HBeAg seroconversion rate,serum ALT normalization rate,response and adverse reactions 3,6,9,12,15,18 months after treatment were observed.Results The HBV-DNA negative conversion rate and HBeAg negative conversion rate significantly increased 6 months after treatment,and still continued to rise,but stabilized.The HBeAg seroconversion rate was 0.00% 3 months after treatment.It increased 6,9 months after treatment,and continued to rise,but stabilized.The ALT of all patients recovered to normal level 9 months after treatment,and the recovery rate was 100.00%.The complete response rate 18 months after treatment was 34.83%,the complete response rate was 11.24%,and the overall response rate was 46.07%.There were 9 patients with abnormal renal function,but without further deterioration,and there were no other serious adverse reactions and complications.Conclusion Adefovir dipivoxil capsule for HBeAg-positive patients with chronic hepatitis B has proved efficacy and it is relatively safe and reliable.But the kidney toxicity should be noticed.