阿德福韦酯联合拉米夫定治疗HBeAg阳性慢性乙肝的疗效观察

Efficacy of adefovir dipivoxil combined with lamivudine for HBeAg-positive chronic hepatitis B

目的探讨阿德福韦酯联合拉米夫定在HBeAg阳性慢性乙肝治疗中的应用价值。方法选择2010年1月～2011年12月我院治疗的100例慢性乙肝患者作为研究对像,随机分为治疗组(阿德福韦酯联合拉米夫定治疗)和对照组(拉米夫定治疗)各50例,比较两组的疗效及治疗后不同时间肝功能指标的变化情况、HBV-DNA转阴率情况。结果观察组治疗24周后,无效仍有10例,总有效率80.00%,对照组无效18例,总有效率64.00%,两组总有效率经χ2检验处理,差异有统计学意义(P<0.05)。两组治疗后不同时间的AST、ALT及TBIL各指标均分别较治疗前明显降低,且观察组较对照组降低更明显,差异有统计学意义(P<0.05)。治疗后12周、24周及48周,两组的HBV-DNA转阴率对比分析显示,差异均无统计学意义(P>0.05)。两组治疗96周后,观察组的HBV-DNA转阴率明显高于对照组,差异有统计学意义(P<0.05)。结论阿德福韦酯联合拉米夫定治疗HBeAg阳性慢性乙肝疗效确切,值得推广和应用。

Objective To investigate the adefovir dipivoxil in combination with lamivudine in HBeAg-positive chronic hepatitis B treatment. Methods All of 100 patients with chronic hepatitis B patients in our hospital from January 2010 to December 2011, as a study on the like, were randomly divided into treatment group （treatment） in combination with lamivu dine, adefovir dipivoxil and the control group （lamivudine treatment）, the efficacy and liver function indicators in different time after treatment, HBV-DNA negative conversion rate were compared. Results Observation group after 24 weeks of treatment, invalid still 10 cases, the total effective rate was 80.00%, invalid control group 18 cases, the total effective rate was 64.00%, the total effective rate by x2 test after treatment had significant difference （P 〈 0.05）. After treatment, at dif- ferent times of AST, ALT and TBIL indicators respectively as compared to before treatment was significantly reduced, and the observati^m group than in the control group signifieant}y decreased, the two groups statistically significant differenee（P 〈 0.05）. After 12 weeks of treatment, 24 weeks and 48 weeks, the two groups of HBV-DNA negative rate eomparalive analysis show no significant difference （P 〉 0.05）. The results show that the two groups after 96 weeks of treatment, the HBV-DNA negative rate of the observation group was signifieanlly higher than that in the control group, significant differenees exist （P〈 0.05）. Conclusion Adefovir dipivoxil in eombinalion with lamivudine in the treatment of HBeAg-positive chronic hepatitis B is effective, and worthy of promotion and application.