阿德福韦酯治疗慢性乙型肝炎133例临床疗效观察

目的观察阿德福韦酯治疗慢性乙型肝炎(CHB)的疗效。方法 133例CHB患者,分为未治疗组101例和拉米夫定(Lamivudine,LAM)耐药组32例。所有患者给予阿德福韦酯胶囊10mg/d,连续治疗48周,并采用全自动生化分析仪、化学发光仪和实时荧光定量PCR法检测患者治疗前、治疗后第12、24、48周ALT、HBeAg水平及HBVDNA载量,以评估疗效。结果未治疗组患者治疗48周后,ALT、HBeAg水平及HBV DNA载量均明显下降(P<0.05)。LAM耐药组,不同变异位点基因型的患者HBVDNA载量无明显改变;治疗24周后与治疗前比较,ALT、HBeAg水平及HBV DNA载量均明显下降(P<0.05);治疗48周后与治疗12周后比较各指标亦明显下降(P<0.05)。结论应用阿德福韦酯治疗可有效降低CHB患者ALT、HBeAg水平及HBV DNA载量,对LAM耐药患者亦有明显效果。

Efficacy of Adefovir dipivoxil treatment in 133 patients with chronic hepatitis B

Objective To observe the efficacy of Adefovir treatment in patients with chronic hepatitis B virus infection.Methods One hundred and thirty-three chronic hepatitis B patients were selected,and divided into the no-treatment group with 101 cases and Lamivudine resistance group with 32 cases.All of the patients were given Adefovir dipivoxil for continuous 48 weeks.The automatic biochemistry analyzer,chemical luminescence instrument and real-time fluorescence gene amplification device were used.ALT,HBeAg and HBV DNA levels were detected in their serum at the first,12th week,24th week,48th week to evaluate the therapeutic effect.Results The ALT,HBeAg and HBVDNA levels of the no-treatment group dropped significantly(P<0.05).The HBV DNA level was not significantly different in the patients with various in Lamivudine-resistance mutations group.Compared with pretherapy, the levels of ALT,HBeAg and HBV DNA dropped significantly 24 weeks after Adefovir treatment(P<0.05).After 48 weeks,the levels dropped significantly than those after 24 weeks(P<0.05).Conclusion Adefovir dipivoxil can effectively reduce the levels of ALT,HBeAg and HBVDNA of the patients with chronic hepatitis B,including Lamivudine-resistance patients.