阿德福韦酯治疗老年慢性乙型肝炎的临床疗效分析

目的 探讨阿德福韦酯治疗老年乙型肝炎的有效性和安全性.方法 选2006年1月～2010年12月间收治的老年慢性乙型肝炎患者80例给予阿德福韦酯治疗,并与采用拉夫米定治疗的80例老年乙型肝炎患者进行对照比较,观察血常规、血糖、血肌酐、尿素氮、胆碱酯酶、谷丙转氨酶、谷草转氨酶、总胆固醇,总甘油三酯等以及HBsAg、HBeAg、HBeAb定量值和HBV DNA定量,耐药率和不良反应.结果 治疗第6、12、18、24个月及停药1年后肝功指标复常率观察组与对照组分别为36.25％、56.25％、77.50％、90.00％、88.75％和32.50％、43.75％、57.50％、68.75％、56.25％；血病毒量阴转率分别为16.25％、32.50％、51.25％、68.75％、60.00％和13.75％、16.25％、22.50％、21.25％、20.00％；乙肝示志阴转率分别为16.25％、32.50％、48.75％、62.50％、58.75％和13.75％、21.25％、26.25％、33.75％32.50％；两组比较差异有统计学意义(P＜0.05)；血粒细胞降低率两组比较差异无统计学意义(P＞ 0.05).在6、12、18、24个月时HBV-DNA水平完全抑制观察组分别为7、11、17和36例,对照组为2、12、16和32例,两组差异无统计学意义(P＞0.05).部分抑制观察组为28、25、23和20例,对照组为31、29、21、19例,两组差异无统计学意义(P＞0.05).治疗过程中所有患者均未观察明显的不良反应.未出现血糖、血脂、甲胎蛋白等指标的明显异常情况.结论 老年慢性乙型肝炎患者应用阿德福韦酯安全有效.

Analysis of the clinical efficacy for adefovir dipivoxil in the treatment of elderly patients with chronic hepatitis B

OBJECTIVE To investigate the efficacy and safety of adefovir dipivoxil in the treatment of elderly hepatitis B.METHODS 80 cases of elderly patients with chronic hepatitis B from January 2006 to December 2010 were chosen,and they were given with adefovir dipivoxil treatment.Compared with 80 cases of elderly patients with hepatitis B in the treatment of Lamivudine.The blood,blood glucose,serum creatinine,blood urea nitrogen,cholinesterase,alanine aminotransferase,aspartate aminotransferase,total cholesterol,total triglycerides,and HBsAg,HBeAg,HBeAb and the quantitative value of HBV DNA quantitative resistance rates and adverse reaction were compared.RESULTS The recovery rate of liver function 6,12,18,24 months and 1 year after treatment and after withdrawal in the observation group and the control group were 36.25%,56.25%,77.50%,90.00%,88.75% and 32.50%,43.75%,57.50%,68.75%,56.25%.The negative rate of blood viral load were 16.25%,32.50%,51.25%,68.75%,60.00% and 13.75%,16.25%,22.50%,21.25%,20.00%.The negative conversion rate of hepatitis B were 16.25%,32.50%,48.75%,62.50%,58.75% and 13.75%,21.25%,26.25%,33.75%,32.50%.The cases of HBV-DNA levels completely inhibited were 7,11,17,36 cases and 2,12,16,32 cases respectively in observation group and control group.The partially inhibited were respectively 28,25,23,20 cases and 31,29,21,19 cases in the observation group and the control group.In the course of treatment,all patients were without obvious adverse reactions.It didn’t appear obvious abnormalities of glucose,lipids,alpha-fetoprotein and other indicators.CONCLUSION The application of adefovir dipivoxil in the treatment of patients with chronic hepatitis B is safe and effective.