拉米夫定耐药后联合阿德福韦酯治疗慢性乙型肝炎的临床研究

目的观察拉米夫定耐药后联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法拉米夫定耐药慢乙型肝炎患者68例,随机分为阿德福韦酯治疗组、拉米夫定和阿德福韦酯联合治疗组,每组34例,动态观察患者血清HBV DNA和ALT变化。结果联合治疗组HBV DNA低于检测下限率在12、24、48、72、96周时分别为26.5%、41.2%、50.0%、76.5%、85.2%,阿德福韦酯治疗组分别为20.5%、26.5%、35.3%、44.1%、52.9%,在72、96周时差异有统计学意义(χ2值分别为7.43、8.34,P值均<0.05);联合治疗组ALT复常率在12、24、48、72、96周时分别为58.3%、66.7%、75.0%、79.1%、83.3%,阿德福韦酯治疗组分别为22.2%、50.0%、61.1%、72.2%、77.7%,在12周时差异有统计学意义(χ2=5.48,P<0.05)。结论阿德福韦酯单独或联合拉米夫定,对拉米夫定耐药的慢性乙型肝炎均有治疗作用;联合用药效果更好。

Clinical effects of Adefovir dipivoxil combined with Lamivudine in theatment of Lamivudine-resistant chronic hepatitis B

Objective To observe the therapeutic effect of adefovir dipivoxil combination with lamivudine in the treatment of lamivudine-resistant chronical hepatitis B.Methods A total of 64 patients with lamivudine-resistant chronic hepatitis B were divided into two groups: combination therepy group and monotherapy group,with 34 cases in each group.Changes in serum HBV DNA and liver functions were dynamically monitored.Results At the end of the 12th,24th,48th,72th and 96nd week of treatment,the rates of sera under the...