拉米夫定联合阿德福韦酯治疗慢性乙型肝炎的临床研究

Lamivudine combined with adefovir dipivoxil for 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84例慢性乙型肝炎患者,随机分为拉米夫定组42例,给予拉米夫定100mg/d、拉米夫定联合阿德福韦酯治疗组42例,给予拉米夫定100mg/d、阿德福韦酯10mg/d。均给予常规护肝及支持对症治疗。在治疗24、48周时观察两组患者肝功能、HBeAg阴转率和HBeAg血清转换率,比较两组ALT复常情况和不良反应发生情况。结果:治疗后两组患者HBV DNA均较基线值降低,且随治疗时间延长降低更明显;治疗24周时两组患者HBV DNA阴转率相似,治疗48周时B组与A组相比差异具有显著性;两组患者治疗后HBeAg阴转率、HBeAg血清转换率未见统计学差异;B组患者治疗48周时ALT复常率与A组相比差异具有显著性;两组均未见严重不良事件。结论:拉米夫定联合阿德福韦酯与单用拉米夫定相比可以有效治疗慢性乙型肝炎,值得临床推广。

Objective To evaluate the efficacy of lamivudine （LAM） combined with adefovir dipivoxil （ADV） on chronic hepatitis B. Methods 84 patients with chronic hepatitis B were randomized into 2 groups, Group A received 100 mg/d of LAM, and Group B received 100 mg/d of LAM and 10 mg/d of ADV. All patients received treatments for 48 weeks. The liver function, and negative rate and seroconversion rate of HBeAg at week 24 and 48 after treatment were observed. The normalization of ALT and adverse drug reaction of the 2 groups were compared. Results Serum levels of HBV DNA in the 2 groups were decreased with time after the treatment. The HBV DNA seroconversion rate was similar between the two groups at week 24, and that was significantly different at week 48. The negative rate and seroconversion rate of HBeAg were not significant different between the 2 groups. At week 48, the normalization rate of ALT in Group B was significantly different from that in Group A. No severe adverse events was observed in the 2 groups. Conclusion LAM combined with ADV can more effectively treating chronic hepatitis B than LAM alone.