阿德福韦酯联合拉米夫定治疗慢性乙型肝炎YMDD变异的临床疗效观察

Effect of adefovir dipioxil in combination with lamivudine on treatment of chronic hepatitis B with YMDD mutations

目的探讨阿德福韦酯联合拉米夫定治疗慢性乙型肝炎YMDD变异的临床疗效,以达到满意治疗效果。方法 123例慢性乙型肝炎YMDD变异的患者随机分为观察组和对照组,观察组给予阿德福韦酯10mg/d联合拉米夫定100mg/d治疗,对照组只给予阿德福韦酯10mg/d,疗程96周,观察两组ALT和HBV DNA的改变。结果治疗后两组ALT和HBV-DNA均明显降低,与治疗前比较差异均具有统计学意义(P<0.05),两组治疗后各观察点的ALT和HBV-DNA比较差异均无统计学意义,其中,两组96周和72周时的ALT比较差异均无统计学意义;观察组与对照组YMDD变异株的检测阳性率分别为0和28.33%,差异有统计学意义(P<0.05)。结论对慢性乙型肝炎YMDD变异的患者采用阿德福韦酯联合拉米夫定或单用阿德福韦酯,其临床效果相似。

OBJECTIVE To investigate the effect of adefovir dipioxil in combination with lamivudine on treatment of chronic hepatitis B with YMDD mutations so as to achieve a satisfying effect.METHODS A total of 123 patients with YMDD mutations chronic hepatitis B were randomly divided into the investigation group and the control group.They were all given lamivudine 100 mg/d,and the investigation group was treated with adefovir dipioxil 10 mg/d additionally while the control group was only given the adefovir dipioxil for a treatment course of 96 weeks,the changes of ALT and HBV DNA levels in the two groups were evaluated and compared.RESULTS The ALT and HBV DNA levels in the both two groups were all decreased significantly,as compared with those before the treatment,the difference was statistically significant（P0.05）.The difference in the ALT level or the HBV DNA level between the two groups after the treatment was not statistically significant,the difference in the ALT level in the 96th week or the 72nd week between the two groups was not statistically significant.The positive rate of YMDD mutation was 28.33% in the control group,higher than 0 in the investigation group,the difference was statistically significant（P0.05）.CONCLUSION The present study concluded that the effect of the combination of adefovir dipioxil and lamivudine is similar to single adefovir dipioxil in the treatment of chronic hepatitis B with YMDD mutations.