阿德福韦酯联合拉米夫定治疗慢性乙型肝炎的临床观察

目的：观察阿德福韦酯联合拉米夫定治疗慢性乙型肝炎的临床疗效。方法：将2007年6月--2010年9月在我院门诊及住院的108例乙肝病毒e抗原（HBeAg）阳性的慢性乙型肝炎患者随机分为治疗组和对照组，治疗组（56例）采取阿德福韦酯联合拉米夫定治疗；对照组（52例）单用拉米夫定治疗。检测并比较2组治疗前后的丙氨酸氨基转移酶（ALT）、HBeAg、乙肝病毒脱氧核糖核酸（HBV-DNA）转阴率，临床疗效及不良反应发生率等。结果：治疗3、6、12个月后，治疗组ALT明显降低，2组比较差异有统计学意义（p〈O．05）；HBeAg72．HBV-DNA转阴率明显高于对照组（P〈0．05或P〈0．01）；治疗12个月后治疗组总有效率（92．86％）与对照组（73．08％）比较，差异有统计学意义（P〈0．01）。治疗组有3例（5．36％）出现耐药性，对照组有9例（17．3％）出现耐药性（P〈0．05）。2组均未见严重不良反应发生。结论：阿德福韦酯联合拉米夫定治疗慢性乙型肝炎，可明显改善患者的肝功能，降低耐药性。

Clinical Observation of Adefovir Dipivoxil Combined with Lamivudine in the Treatment of Chronic Hepati- tis B

To observe the clinical efficacy of combination therapy of adefovir and lamivudine in the treatment of chronic hepatitis B, and to carry out analysis and summary. METHODS： By retrospective method, 108 outpatient and hospitaliza- tion patients with HBeAg positive chronic hepatitis B in our hospital from Jun. 2007 to Sept. 2010 were divided into treatment group and control group according to disease condition and will. Treatment group was given adefovir dipivoxil combined with lami- vudine; control group was given lamivudine alone. ALT was detected before and after treatment, HBeAg and HBV-DNA negative rate were calculated before and after treatment, and clinical efficacy and adverse reaction rates were evaluated, too. RESULTS： Af- ter 3, 6, 12 months of treatment, liver function index ALT value reduced significantly in treatment group, there was statistical sig- nificance between 2 groups （P〈0.05） ; HBeAg and HBV-DNA negative rate was significantly higher than that of control group （P〈0.05 or P〈0.01） ; after 12 months of treatment, there was statistical significance in total effective rate of drug combination group （92.86%） and control group （73.08%, P〈0.01）. After 12 months of treatment, 3 patients in the treatment group suffered from drug resistance （5.36%）, and 9 cases in the control group （17.3%）, there was significant difference （P〈0.05）. There was no statistical significance in 2 groups. CONCLUSION： Adefovir dipivoxil combined with lamivudine in the treatment of chronic hepatitis B can significantly improve the patient＇s liver function, decrease drug resistance, obtain affirmed curative effect.