国产阿德福韦酯联合拉米夫定治疗拉米夫定耐药的慢性乙型肝炎患者的临床疗效观察

目的:观察拉米夫定(LAM)与国产阿德福韦酯(ADV)联合治疗拉米夫定耐药的慢性乙型肝炎(CHB)临床疗效。方法:24例LAM耐药的CHB患者采用ADV10mg/d,联合LAM100mg/d治疗,疗程52周。观察用药12、24、52周患者血清乙型肝炎病毒(HBV-DNA)、谷丙转氨酶(ALT)的变化,以及乙型肝炎e抗原(HBeAg)阴转率和血清转换率。结果:患者在治疗12、24、52周时血清HBV-DNA、ALT与治疗前比较均有显著的下降,差异均有统计学意义,52周时患者HBV-DNA阴转率79.2%,ALT恢复至正常的百分比为83.3%。结论:阿德福韦酯联合拉米夫定治疗拉米夫定耐药慢性乙型肝炎患者在病毒学、血清学及生化学方面取得较好疗效,耐药率低。

Clinical Study on Domestic Adfovir Dipivoxil and Lamivudine in Treatment Chronic Hepatitis B Patients with Lamivudine Resistance

Objective:To investigate the domestic adefovir dipivoxil and lamivudine in treatment chronic hepatitis B patients with lamivudine resistance.Methods:24 Patients with LAM resistance chronic hepatitis B were treated with ADV 10 mg/d and LAM 100 mg/d for 52 weeks,levels of HBV-DNA,ALT,HBeAg loss rate and seroconversion rate were detected at different time during the treatment.The efficacy was evaluated at 12th,24th and 52nd week.Results:The levels of HBV-DNA and ALT were significantly decreased after treatment for 12,24,52 weeks.At 52nd week,ALT returned to the normal in 83.3% patients,loss rate of HBV-DNA was 79.2%.Conclusion:ADV combined with LAM has good curative effects in the virology,serology and biochemical aspect of LAM resistance patients with lower medicine resistance.