阿德福韦酯联合双环醇治疗慢性乙型肝炎疗效观察

目的观察阿德福韦酯与双环醇联合治疗慢性乙型肝炎的临床疗效。方法将69例慢性乙型肝炎患者完全随机分为观察组（35例）和对照组（34例）。观察组口服阿德福韦酯10mg，1次／d；同时服用双环醇50mg，3次／d；对照组仅给予口服阿德福韦酯10mg，1次／d；2组均连续用药48周，观察2组治疗前后氨基转移酶水平及病毒学标志物方面的改变。结果治疗结束后2组血清氨基转移酶均有明显改善，观察组与对照组比较差异有统计学意义ALT：（41±17）U／L比（50±14）U／L，AST：（36±21）U／L比（44±25）U／L，P〈0．05]；观察组和对照组治疗后HBV—DNA水平与治疗前相比差异均有统计学意义（2．83±1．03）lg拷贝／ml比（5．25±1．13）lg拷贝／ml，（3．25±1．09）lg拷贝／ml比（5．36±1．08）lg拷贝／ml，P〈0．05]，但2组治疗后比较差异无统计学意义（P〉0．05）；治疗结束后观察组HBV．DNA阴转率68．6％（24／35）]明显高于对照组52．9％（18／34）]，2组比较差异有统计学意义（P〈0．05），HBeAg阴转率和HBeAg血清学转换率2组比较差异均无统计学意义（P〉0．05）。2组均未发生明显不良反应。结论阿德福韦酯与双环醇联合应用治疗慢性乙型肝炎在肝功能及病毒学改善方面有较好疗效，且安全性良好。

Efficacy and safety of adefovir dipivoxil combined with bicyclol in treatment of chronic hepatitis B

Objective To analyze the efficacy and safety of adefovir dipivoxil combined with bicyclol in treatment of chronic hepatitis B. Methods A total of 69 patients with chronic hepatitis B were randomized into observation group（35 cases）and control group （34 cases）. The patients in the observation group received adefovir dipivoxil and bicyclol orally for 48 weeks and control group received adefovir dipivoxil alone for 48 weeks. The serum aminotransferace（ALT/AST）, HBV-DNA, HBeAg/antiHBe were observed before and after treatment. Results Compared with pretreatment, the serum aminotransferace was all decreased in two groups. There was a significant difference between two groups ALT： （41 ＋ 17 ） U/L vs （50 ＋ 14） U/L, AST： （36 ＋ 21 ） U/L vs （44 ＋ 25 ） U/L, P 〈 0.05 ] ; compared with pertreatment, the HBV-DNA was decreased obviously in observation group and control group. HBV-DNA negative conversion rate was significantly higher in the observation group than that in the control group 68.6% （24/35）vs 52.9% （18/34）, P 〈 0.05 I. There were no statistical differences between the two groups regarding HBeAg loss rate and HBeAg seroconversion rate. There were no obvious adverse reactions in the study. Conclusions Administration of adefovir dipivoxil combined with bicyclol is effective and safe in the treatment of chronic hepatitis B, especially in HBV-DNA negative conversion and the live function.