拉米夫定联合阿德福韦酯治疗耐拉米夫定乙型肝炎效果观察

Effect of Lamivudine Combined with Adefovir Dipivoxil in the Treatment of Lamivudine Rresistant Hepatitis B

目的:探讨拉米夫定联合阿德福韦酯治疗耐拉米夫定乙型肝炎效果和安全性。方法:选择我院感染科与消化内科于2010年1月—2015年2月收治的60例耐拉米夫定乙型肝炎患者,随机分为A组和B组,各30例。A组采用单独阿德福韦酯治疗,B组采用拉米夫定联合阿德福韦酯治疗,疗程12个月。比较两组患者治疗第12w、24w和48w时肝功能和血清HBV-DNA。结果:治疗48w时,B组HBV-DNA转阴率、HBe Ag转阴率、HBe Ag/抗HBe转换率均显著高于A组(P<0.05)。B组治疗24w、48w时ALT复常率显著高于A组(P<0.05)。两组均无严重不良反应。结论:拉米夫定联合阿德福韦酯能显著改善耐拉米夫定乙肝患者肝功能、抗原学和病毒学指征,具有明显治疗作用。

Objective: To investigate the effect and safety of lamivudine combined with adefovir dipivoxil in the treatment of lamivudine resistantHBV. Methods: 60 patients with lamivudine resistant hepatitis B from January 2010 to February 2015 in our hospital were randomly divided intoA group and B group, with 30 cases in each group. The A group used adefovir dipivoxil treatment, B group was treated with lamivudine combinedwith adefovir dipivoxil, for 12 months. the efficacy and safety of two groups was compared at 12w, 24w and 48w. Results: HBV-DNA negativerate, HBeAg seroconversion rate, HBeAg/anti HBe conversion rates of group B at 48w were significantly higher than group A (P<0.05). The ALTcomplex rate of B group was significantly higher than that of group A (P<0.05)at 24w and 48w. There were no serious adverse reactions in thetwo groups. Conclusion: Combination of lamivudine and adefovir dipivoxil can significantly improve the resistance to lamivudine in patients withchronic hepatitis B liver function, antigen and virological testify and has obvious therapeutic effect.