阿德福韦酯与拉米夫定治疗合并肺结核的慢性乙型肝炎的疗效与安全的回顾性分析

目的：观察抗病毒药物阿德福韦酯治疗肺结核合并乙型肝炎的临床治疗效果。方法：回顾性分析了采用阿德福韦酯和拉米夫定进行治疗的112例肺结核合并慢性乙肝患者，抗结核治疗均采用2HREZ/7HRE方案。结果：在治疗6、12个月后与拉米夫定治疗组相比，阿德福韦酯治疗组的血清HBV-DNA拷贝数显著下降（P<0.05）；两个治疗组肝功能指标较治疗前有显著下降，但两个治疗组的下降值并未存在显著性差异。结论：患有慢性乙肝的肺结核患者在抗结核治疗的同时，应用阿德福韦酯比拉米夫定更为有效地抑制乙肝病毒的复制，减轻病毒对肝脏的损害，增强患者肝脏对抗结核药物的耐受性，并改善患者的肝脏功能，从而使患者能顺利完成抗结核治疗。

Clinical Research of Adefovir Dipivoxil or Lamivudine on Patients with Pulmonary Tuberculosis Combined with Type B Hepatitis

[Abstract]Objective:To observe the efficacy on patients with pulmonary tuberculosis combined with type B hepatitis treated by adefovir dipivoxil. Methods: The efficacy on 112 patients with pulmonary tuberculosis combined with type B hepatitis treated by adefovir dipivoxil or lamivudine was retrospectively analyzed, and 2HREZ/7HRE method was used to treat antituberculosis. Results: Compared with lamivudine treated group, the serum HBV-DNA copy number of adefovir dipivoxil treated group was noticeably reduced after 6 or 12 months treatment( P<0.05 ); the liver function index of both groups were significantly decreased, but without any significant differences. Conclusion: During antituberculosis treatment on patients with pulmonary tuberculosis combined with type B hepatitis, compared with lamivudine treated group, application of adefovir dipivoxil could more effectively inhibit hepatitis B virus replication, alleviate virus on liver damage, enhance drug tolerability on patients with liver tuberculosis, and improve patient's liver function, so that the patients could successfully complete the antituberculosis treatment.