替比夫定联合阿德福韦酯治疗HBeAg阳性慢乙肝临床观察

One-year Clinical Observation on Combination of Telbivudine and Adefovir in Treatment of HBeAg Positive Chronic Hepatitis B Patients

目的探讨替比夫定联合阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的疗效和安全性.方法 216例HBeAg阳性慢性乙型肝炎患者被随机分为替比夫定及阿德福韦酯联合治疗组(A组)72例,替比夫定组72例(B组),阿德福韦酯组(C组)72例,比较3组在治疗后12周、24周、36周、48周时的疗效.结果治疗后12周、24周、36周、48周时,A组HBV-DNA转阴率、HBeAg血清学转换率和ALT复常率均高于B组及C组,均有显著差异(P<0.05).结论慢乙肝初始治疗选择替比夫定联合阿德福韦酯抗病毒治疗48周疗效显著,发生临床耐药率极低,安全性高,值得进一步尝试.

Objective To determine the efficacy and safety of telbivudine and adefovir combination therapy on HBeAg positive chronic hepatitis B patients.Methods 216 HBeAg positive chronic hepatitis B patients admitted to our department were randomly divided into 3 groups： telbivudine and adefovir combination therapy group（group A,72 patients）,telbivudine therapy group（group B,72 patients） and adefovir therapy group（group C, 72 patients）.The efficacy at 12th,24th,36th and 48th week was carefully analyzed.Result Group A was found to have higher HBV DNA negative rate,higher HBeAg serum conversion rate,and more ALT normalization than group B and C,the difference was statistically significant（P0.05）.Conclusion According to our one-year observation,therapeutic strategy with telbivudine and adefovir combination in HBeAg positive chronic hepatitis B patients has higher efficacy and safety and lower drug resistance,which is strongly recommended.