阿德福韦酯治疗HBeAg阳性的慢性乙型肝炎38例

目的观察阿德福韦酯对HBeAg阳性的慢性乙型肝炎患者的临床疗效及耐药情况。方法将70例患者随机分为两组，治疗组38例给予阿德福韦酯片10mg，对照组32例给予拉米夫定片0．1g，两组均为1次／d，服用48周。治疗24周和48周后观察丙氨酸氨基转移酶（ALT）复常率、HBeAg的阴转率及血清学转换率、HBV—DNA定量、HBV—YMDD变异株。结果两组临床疗效无显著差异（P〉0．05）。治疗组在治疗过程中未发现肝功能再次异常，无耐药情况发生；对照组在治疗24周后肝功能轻度反弹，且出现病毒变异株。结论阿德福韦酯治疗HBeAg阳性的慢性乙型肝炎耐药率低，疗效较好。

Clinical Observation on Adefovir Dipivoxil for Treating HBeAg-Positive Chronic Hepatitis B in 38 Cases

Objective To observe the efficacy and resistance of adefovir dipivoxil for treating chronic hepatitis B. Methods 70 HBeAg- positive patients were diyided randomly into treatment group and control group. The patients in the treatment and control groups were respectively given adefovir dipivoxit 10 mg and lamivudine 0. 1 g, once a day for 48 weeks. ALT normalization, HBeAg negative conversion rate, HBeAg seroconversion rate, HBV- DNA level and HBV- YMDD variants were assessed after 24, 48 weeks of treatment. Results There was no significant difference between the two groups in clinical effect （P 〉 0. 05）. The repeated abnormal liver function was not found again, no resistance case occurred in the treatment group during the treating course. The liver function was rebound lightly at 24 week in the control group and some virus variants with resistance to lamivudine were found. Conclusion Adefovir dipivoxil is efficacious for HBeAg- positive chronic hepatitis B with low drug resistance rate.