阿德福韦酯治疗慢性乙型肝炎的临床研究

目的观察阿德福韦酯（ADV）治疗HBeAg阳性慢性乙型肝炎的疗效和安全性。方法将43例慢性乙型肝炎患者分为初始治疗组25例和拉米夫定（LAM）耐药组18例，分别给予ADV 10mg口服，每日1次，治疗48周。结果ADV初治组和拉米夫定（LAM）耐药组患者在治疗48周时，ALT复常率分别为72．0％和66．7％，血清HBVDNA阴转率分别达48．0％和44．4％，HBeAg转阴率分别为28．0％和27．8％，HBeAg／HBeAb血清转换率分别为20．0％和16．7％。两组血清HA、LN和PC3均明显下降，两组差异无统计学意义（P〉0．05）。两组患者耐受性良好，无明显肾功能损伤等不良反应。结论ADV治疗慢性乙型肝炎，对初治及拉米夫定耐药患者均能有效控制病毒复制，改善肝功能，促使HBeAg血清学转换，长期服药安全性好。

A clinical trial of adefovir dipivoxil in treatment of patients with naive chronic hepatitis B or lamivudine-resistent mutant infection

Objective To evaluate the efficacy and safety of adefovir dipivoxil (ADV) in treatment of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Method 43 patients with chronic hepatitis B including 25 naive patients and 18 lamivudine-resistant patients,were treated with adefovir dipivoxil 10mg daily. The efficacy was evaluated at 12th month,24th month,36th month and 48th month. Results At the 48th month,the rates of ALT becoming normal were 72.0% and 66.7% in naive and in lamivudine-resistant group,respectively;The negative rates of HBV DNA were 48.0% and 44.4%,respectively;Negative rates of HBeAg were 28.0% and 27.8%,and the seroconversion rates of HBeAg were 20.0% and 16.7%,respectively;Hepatic fibrosis index as HA,LN,PC3 were decreased obviously in two groups,but there was no statistically significant difference between the two groups. Conclusions Adefovir dipivoxil can effectively inhibit HBV replication,normalize ALT and enhance transformation from HBe-antigen to anti-HBe for cases with naive patients and lamivudine-resistant patients. It is safe and has a good tolerance.