阿德福韦酯联合拉米夫定治疗HBV-YMDD变异的研究

目的比较阿德福韦酯联合拉米夫定和单用阿德福韦酯治疗YMDD变异的慢性乙型肝炎的疗效和安全性。方法将112例在拉米夫定治疗过程中出现YMDD变异的慢性乙型肝炎患者随机分为两组(各56例),治疗组:继续接受拉米夫定100mg·d-1治疗,全程联合阿德福韦酯10 mg·d-1;对照组:拉米夫定100 mg·d-1和阿德福韦酯10 mg·d-1联合治疗12周后单用阿德福韦酯10 mg·d-1,疗程96周。结果两组患者治疗后ALT、AST水平均较治疗前显著改善(P0.05);治疗组治疗48周,96周时肝功能ALT、AST改善优于对照组(P0.05);HBV DNA转阴率显著高于对照组(P0.05)。结论阿德福韦酯对YMDD变异的慢性乙型肝炎患者有良好的疗效和安全性,联合拉米夫定临床疗效更显著。

Therapeutic effect and safety of lamivudine combined with adefovir dipivoxil treatment in hepatitis B of HBV-YMDD

Objective To evaluate the clinical efficacy and safety of lamivudine（LAM）combined with adefovirdipivoxil（ADV）in treatment in hepatitis B of HBV-YMDD.Methods A hundred and twelve patients with HBV-YMDD of chronic hepatitis B were randomly divided into the treated group who were given LAM combined with ADV and control group who were only given ADV after LAM combined with ADV in first 12 weeks.The patients in both groups were followed-up for 96 weeks.Results At the end of treatment the patients in two groups had their liver founction tests improved.The effects in treated group were superior to those in control group after 48-and 96-week treatment.No obvious adverse reactions were found in patients when taking the medicine.Conclusion ADV combined with LAM have better clinical efficacy and safety in patients of hepatitis B of HBV-YMDD.The clinical efficacy in LAM combined with ADV is superior to those in ADV only.The combined use of lamivudine and adefovir is safe and effeetive for hepatitis B in HBV-YMDD mutant obviously.