拉米夫定联合阿德福韦酯与阿德福韦酯单药治疗拉米夫定耐药患者的疗效对比

Comparative study of adefovir dipivoxil combined with lamivudine and adefovir dipivoxil monotherapy in the treatment of chronic hepatitis B patients with lamivudine resistance

目的观察拉米夫定和阿德福韦酯联合治疗与阿德福韦酯单药治疗拉米夫定耐药的慢性乙肝患者的疗效。方法 60例拉米夫定耐药的慢性乙肝患者采用随机数字表法分为联合组(30例)与单药组(30例),联合组服用拉米夫定100mg/d和阿德福韦酯10mg/d,96周;单药组服用阿德福韦酯10mg/d,96周。结果治疗96周后,联合组HBVDNA应答率、HBeAg转换率、ALT复常率比例分别为93.3%、53.3%、83.3%,高于单药组的66.7%、26.7%、56.7%,两组比较差异均具有统计学意义。治疗96周后,联合组未出现耐药患者,而单药组有6例患者出现耐药。结论拉米夫定联合阿德福韦酯联合治疗拉米夫定耐药的患者远期疗效优于阿德福韦酯单药治疗。

Objective To evaluate the effect of adefovir dipivoxil combined with lamivudine treatment and adefovir dipivoxil monotherapy in the treatment of chronic hepatitis B patients with lamivudine resistance. Methods Sixty chronic hepatitis B patients with lamivudine resistant were divided into the combination and monotherapy group. The combination group applied adefovir dipivoxil 10 mg/d and lamivudine 100 mg/d for 96 weeks, while the monotherapy group applied adefovir dipivoxil 10 mg/d for 96 weeks. Results After treatment, the negative rate ofHBV DNA, HBeAg, ALT were 93.3%, 53.3%, 83.3% in the combination group and 66.7%, 26.7%, 56.7% in the monotherapy group, with statistically significant difference between the two groups. No cases of resistance was found in the combination group, but 6 were found in the monotherapy group. Conclusion Adefovir dipivoxil com- bined with lamivudine was superior to adefovir dipivoxil monotherapy in the treatment of chronic hepatitis B patients with lamivudine resistance.