阿德福韦酯治疗拉米夫定耐药慢性乙肝患者的临床效果分析

Clinical Analysis of Adefovir Dipivoxil in the Treatment of Lamivudineresistant Chronic Hepatitis B Patients

目的探讨阿德福韦酯治疗拉米夫定耐药慢性乙肝患者的临床效果。方法回顾性选取2016年8月—2020年6月期间在厦门市第三医院传染科接受治疗的拉米夫定耐药慢性乙肝患者103例的临床资料,以随机数表法分组。对照组50例患者接受阿德福韦酯治疗,观察组53例患者接受阿德福韦酯+拉米夫定治疗。对比治疗后患者治疗效果、不同时间点乙肝病毒脱氧核糖核酸(HBV-DNA)水平及转阴率、谷丙转氨酶(ALT)水平、复常率以及用药期间不良反应发生情况。结果治疗后,观察组有效率为96.23%,高于对照组的70.00%,差异有统计学意义(χ^(2)=12.841,P<0.05)。治疗3个月、6个月、9个月、1年后,观察组HBV-DNA水平更低于对照组,差异有统计学意义(P<0.05)。治疗3个月、6个月、1年后,观察组HBV-DNA转阴率更高于对照组,差异有统计学意义(P<0.05)。治疗3个月、6个月、9个月、1年后,观察组ALT水平更低于对照组,差异有统计学意义(P<0.05)。治疗1年后,两组ALT复常率对比,观察组更高,差异有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论耐药慢性乙肝患者接受阿德福韦酯治疗取得了显著治疗效果,患者的HBV-DNA水平降低,ALT水平也显著降低,转阴率增高,ALT复常率显著增高,且联合用药并未增加治疗期间不良反应发生率。

Objective To discuss the clinical effect of Adefovir Dipivoxil in the treatment of Lamivudine-resistant chronic hepatitis B patients.Methods A total of 103 patients with Lamivudine-resistant chronic hepatitis B who were treated in the Department of Infectious Diseases of Xiamen Third Hospital from August 2016 to June 2020 were retrospective selected the clinical data,and they were divided into groups by random number table method.50 patients in the control group received Adefovir Dipivoxil treatment,and 53 patients in the observation group received Adefovir Dipivoxil+Lamivudine treatment.After treatment,the treatment effect,hepatitis B virus deoxyribonucleic acid(HBVDNA)level and negative conversion rate,alanine aminotransferase(ALT)level and normalization rate at different time points,and the occurrence of adverse reactions during medication were compared.Results After treatment,the effective rate of the observation group was 96.23%,higher than 70.00% of the control group,the difference was statistically significant(χ^(2)=12.841,P<0.05).After 3 months,6 months,9 months and 1 year of treatment,the HBV-DNA levels in the observation group was lower than the control group,and the difference was statistically significant(P<0.05).After 3 months,6 months and 1 year of treatment,the HBV-DNA negative conversion rates of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After 3 months,6 months,9 months and 1 year of treatment,the ALT levels of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After 1 year of treatment,the comparison of ALT normalization rates between the two groups showed that the observation group was higher than the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Adefovir Dipivoxil treatment has achieved a significant therapeutic effect in patients with drug-resistant chronic hepatitis B.The HBV-DNA level was reduced,the ALT level was also significantly reduced,and the ALT normalization rate was significantly increased,the negative conversion rate was increased.And the combined drug did not increase the incidence of adverse reactions during treatment.