阿德福韦酯联合恩替卡韦治疗耐拉米夫定型慢性乙肝疗效观察

The clinical effect observation of adefovir dipivoxil combined with entecavir on lamivudine-resistant chronic hepatitis B

目的观察阿德福韦酯联合恩替卡韦治疗耐拉米夫定型慢性乙肝的疗效。方法采用前瞻性研究方法,选择2013年9月至2016年1月在我院诊治的耐拉米夫定型慢性乙肝患者98例,根据入院先后顺序分为观察组与对照组,各49例。对照组口服恩替卡韦治疗,观察组在对照组的基础上给予阿德福韦酯治疗,观察两组的治疗效果。结果治疗后观察组的HBVDNA转阴率和HBe Ag阴转率分别为98.0%和85.7%,对照组分别为85.7%和71.4%,观察组均明显高于对照组(P<0.05)。观察组与对照组治疗后的ALT值分别为(46.09±15.98)U/L和(76.13±19.55)U/L,分别低于治疗前的(153.20±33.01)U/L和(151.30±26.02)U/L(P<0.05),且观察组治疗后的ALT值明显低于对照组(P<0.05)。结论阿德福韦酯联合恩替卡韦治疗耐拉米夫定型慢性乙肝,能有效提高HBe Ag阴转率及HBV-DNA阴转率,促进肝功能的改善,有很好的应用价值。

Objective To investigate the curative effect of adefovir dipivoxil combined with entecavir on lamivudineresistant chronic hepatitis B patients. Methods With prospective study, 98 cases of lamivudine-resistant chronic hepatitis B patients treated from September 2013 to January 2016 were randomly divided into control group and observation group according tO the order of hospitalization. The control group accepted oral enteeavir treatment, while the observation group received oral entecavir combined with adefovir dipivoxil. The therapeutic effect of the two groups were observed. Results The rate of the HBV-DNA negative transformation and HbeAg negative transformation in the observation group were 98.0% and 85.7% respectively after therapy, and correspondingly, the rate of which were 85.7% and 71.4% in the control group, the rate of HBV-DNA and HBeAg negative transformation in the observation group were significantly higher than those in the control group （P〈0.05）. After 6 month of therapy, the ALT value were （46.09±15.98） U/L and （76.13±19.55） U/ L in the observation group and the control group, which were higher than pre-therapy, which were （153.20±33.01） U/L and （151.30±26.02） U/L in the observation group and the control group （P〈0.05）, meanwhile, the ALT value was lower in the observation group after treatment than that in the control group （P〈0.05）. Conclusion Combination adefovir dipivoxil with enteeavir could improve HBeAg and HBV-DNA negative transformation and hepatic function significantly, which has great application value on lamivudine-resistant chronic hepatitis B patients .