阿德福韦酯治疗YMDD变异的慢性乙型肝炎的临床研究

目的：阿德福韦酯（ADV）治疗LAM耐药慢性乙型肝炎（CHB）患者的疗效。方法：选择LAM治疗后出现YMDD变异的HBeAg阳性CHB患者89例，其中随机分为（A组）43例接受ADV和LAM联合治疗3个月后，单用ADV治疗1年，B组45例给予ADV联合LAM治疗1年。结果：A、B两组治疗12月后，患者ALT复常率分别是60．5％、88．9％；HBVDNA阴转率分别为41．9％、82．2％，HBeAg阴转率分别是10．3％、29．7％。结论：ADV联合LAM治疗LAM耐药CHB患者有效，长期联合LAM能提高HBVDNA阴转率，有显著的抗病毒效果。

Clinical research of adefovir dipivoxil therapy on hepatitis B patients with YMDD mutation

Objective ： Efficacy of adefovir dipivoxil in treatment of chronic hepatitis B patients with lamivudine resistance. Methods： Choose 89 cases of HBeAg positive patients with lamivudine resistance, among them were randomly divided into 43 cases （group A） received ADV and LAM combination therapy after 3 months,ADV therapy alone for i year,45 cases of group B to give 1 year adefovir dipivoxil combined lamivudine therapy.Results ： A, B two groups of adefovir dipivoxil combined lamivudine treatment in 12 months,the normalization rate of alanine aminotransferase were 60.5%, 88.9%,the negative conversion rate of HBV DNA were 41.9%, 82.2%, the negative conversion rate of HBV DNA were 10.3%, 29.7%. Conclusions ： Adefovir dipivoxil combined lamivudine treatment to be effective chronic hepatitis B patients with lamivudine resistance, can increase the negative conversion rate of HBV DNA ,also have the remarkable antiviral effect.