阿德福韦酯联合拉米夫定治疗慢性乙肝的疗效研究

目的观察阿德福韦酯联合拉米夫定治疗慢性乙肝的临床疗效。方法选择我院2008年1月～2010年1月住院治疗的慢性乙肝患者72例，随机分为联合组（阿德福韦酯联合拉米夫定）和对照组（单独应用阿德福韦酯）各36例．比较两组治疗12个月后的应答率、YMDD变异率、ALT复常率、HBeAg转阴率、HBV—DNA转阴率，并观察用药的安全性。结果联合组的完全应答率达52．8％（19／36），明显高于对照组的27．8％（10／36），两组比较差异有统计学意义（P〈0．01）。对照组ALT复常率为52．8％（19／36），而联合组治疗12个月后ALT复常率为83．3％（30／36），两组比较差异有统计学意义（P〈0．01）。两组治疗12个月后，对照组出现YMDD变异共7例，YMDD变异率为19．4％（7／36），而联合组出现YMDD变异共2例，YMDD变异率为5．6％（2／36），联合组的YMDD变异率明显低于对照组，两组比较差异有统计学意义（P〈0．01）。两组治疗12个月后，对照组HBV—DNA转阴率，联合组HBV—DNA转阴率为61．1％（22／36），两组比较差异有统计学意义（P〈0．01）。两组治疗12个月后，联合组HBeAg转阴率为50．0％（18／36），而对照组HBeAg转阴率为16．7％（6／36），两组比较差异有显著性统计学意义（P〈0．01）。结论阿德福韦酯联合拉米夫定治疗慢性乙肝的疗效优于单独应用阿德福韦酯的疗效，能明显改善患者的肝功能，提高HBV—DNA及HBeAg转阴率。值得广泛推广和应用。

Adefovir dipivoxil combined with lamivudine treatment of chronic hepatitis B

Objective To observe clinical efficacy of Adefovir dipivoxil combined with lamivudine treatment of chronic hepatitis B.Methods Seventy-two patients with chronic hepatitis B were randomly divided into the combination group(adefovir dipivoxil combined with lamivudine) and control group(alone adefovir dipivoxil) of 36 patients Our hospital in January 2008-2010 in January hospitalization,and they were compared after 12 months of treatment response rates,YMDD mutation rate,ALT normalization,HBeAg seroconversion rates,HBV-DNA negative rate,and observe the drug’s safety.Results The complete response rate of the combined group 52.8%(19/36),significantly higher than the 27.8%(10/36),the difference was significant statistically significant(P < 0.01).ALT normalization rate of Control group was 83.3%(30/36),while the combination group after 12 months of treatment ALT normalization rate was 52.8%(19/36),the difference was significant statistically significant(P < 0.01).12 months after treatment in both groups,the control group there were seven cases of YMDD mutation,YMDD mutation rate of 19.4%(7/36),while the combination group were 2 cases with YMDD mutation,YMDD mutation rate of 5.6%(2/36),the United YMDD mutation group was significantly lower than the control group,the difference was significant statistically significant(P < 0.01).12 months after treatment in both groups,HBV-DNA negative control group rate of 61.1%(22/36),and the combined group after 12 months of treatment HBV-DNA negative rate of 27.8%(10/36),the difference There was a significant statistical significance(P < 0.01).Two groups after 12 months of treatment,HBeAg loss rate of the combination group and 50.0%(18/36),while the control group 12 months after HBeAg seroconversion rate of 16.7%(6/36),the difference was significant statistical significance(P < 0.01).Conclusion Adefovir dipivoxil combined with lamivudine treatment of chronic hepatitis B is more effective than adefovir dipivoxil alone treatment,can significantly improve the patient’s liver function,improve the negative rate of HBV-DNA and HBeAg.