阿德福韦酯治疗慢性乙型肝炎临床疗效及影响因素的研究

目的观察国产阿德福韦酯(优贺丁,上海益生源药业有限公司)治疗慢性乙型肝炎临床疗效并评估影响疗效的因素。方法应用国产阿德福韦酯(优贺丁,上海益生源药业有限公司)治疗我院2008年4月至2009年10月收治50例慢性乙型肝炎患者,分别于12、24、48周进行病毒学、血清学及生化学指标的检测,观察抗病毒疗效并评估影响疗效的因素。结果国产阿德福韦酯(优贺丁,上海益生源药业有限公司)治疗48周,HBVDNA阴转率为72.00%,HBeAg血清转换率为23.53%,ALT复常率为74.00%,耐药率为0%;HBeAg阴性的患者的HBVDNA阴转率高于HBeAg阳性患者(P<0.05);基线ALT>5ULN患者的HBVDNA转阴率、HBeAg血清学转换率均高于2～5ULN的患者(P<0.05);治疗24周后HBVDNA阴转的患者与未阴转的患者相比,其48周HBVDNA阴转、ALT复常和HBeAg血清学转换的比例明显增高(P<0.05)。在治疗48周过程中1例治疗过程中发生一过性ALT升高,1例肌酐轻微升高,无一例患者发生严重不良事件而停药。结论国产阿德福韦酯(优贺丁,上海益生源药业有限公司)可以有效抑制慢性乙型肝炎HBVDNA复制,促进ALT复常及HBeAg血清转换,有效改善肝功能,耐药率低,安全性良好。

Efficacy of adefovir dipivoxil(ADV)on patients with chronic hepatitis B and factors of predict efficacy

Objective To investigate the efficiency of on patients with hepatitis B and evaluate the factors of can predict the efficacy. Methods The virology,serology and biochemical indicators of 50 patients who received adefovir dipivoxil for the treatment of chronic hepatitis B were detected and analysised before and at week 12,24 and 48 of the treatment,in order to get the predict efficacy factors of the treatment. Results After 48 weeks of treatment,HBV DNA negative rate was 72.00%,HBeAg seroconvert sion rate was 23.53%,ALT normolization rate was 74.00%,and drug resistant rate was 0,HBV DNA negative rate of HBeAg-negative group was significantly higher than of HBeAg-positive group（P〈0.05）,The rates of HBV DNA negative rate of HBeAg-negative and HBeAg s evaluate eroconversion in patients with base ALT〉5 ULN were significantly higher than those in patients with 2-5 ULN（P〈0.05）;The rates of HBV DNA negative,ALT normalization and HBeAg seroconversion at week 48 after treatment in patients with HBV DNA negative at week 24 were significantly higher（P〈0.05）.In the course no case stopping treatment for severe adverse effect. Conlusion Adefovir dipivoxil can inhibit HBV DNA replicat ion,normalize ALT and promote HbeAg seroconversion,morever the rate of drug resistance is low.It is a safe and effective antiviral drug.