阿德福韦酯治疗拉米夫定耐药的慢性乙型肝炎的疗效观察

目的 观察阿德福韦酯（ADV）治疗拉米夫定（LAM）耐药的慢性乙型肝炎的临床疗效和安全性。方法 随机将81例拉米夫定耐药的HBeAg阳性慢性乙型肝炎患者分为ADV治疗组41例，以ADV联合LAM治疗12周，停用LAM再继续应用ADV治疗36周和LAM治疗组40例，继续应用LAM。结果 ADV治疗组患者在治疗24周和48周时HBV DNA水平下降明显优于LAM组，差异有统计学意义（P〈0．05）；ADV组治疗24周和48周时，血清HBeAg阴转率分别为31．7％和34．1％，血清HBeAg／抗-HBe转换率为24．4％和22．0％，丙氨酸氨基转移酶复常率为56．1％和68．3％，均显著优于LAM组（P〈0．05）。治疗中无不良反应发生。结论 ADV能有效安全地治疗LAM耐药性慢性乙型肝炎患者。

Clinical observation of adefovir dipivoxil in the treatment of patients with lamivudine-resistant chronic hepatitis B

Objective To observe the efficacy and safety of adefovir dipivoxil （ADV） in the treatment of patients with lamivudine-resistant chronic hepatitis B. Methods Eighty-one patients with LAM resistant chronic hepatitis B were randomly divided into ADV（n=41） or LAM（n=40） treatment. 41 patients received ADV and LAM for 12 weeks,and ADV for 36 weeks,and 40 received LAM alone for 48 weeks. Results At 24th and 48th week,the HBV DNA reduction from baseline in ADV-treated patients was significantly greater than in LAM-treated patients;At week 24 and 48,HBeAg negative rate （31.7% and 34.1%）,the rate of HBeAg seroconversion （24.4% and 22.0%） and ALT normalization （56.1% and 68.3% ） in the ADV group were significantly higher than those in the LAM group. Conclusions ADV is effective and safe for the treatment of chronic hepatitis B patients with LAM resistance.