阿德福韦酯治疗拉米夫定耐药性HBeAg阳性慢性乙型肝炎的疗效及安全性分析

目的观察并分析阿德福韦酯（ADV）治疗拉米夫定（LAM）耐药性乙肝病毒e抗原（HBeAg）阳性慢性乙型肝炎的疗效及安全性。方法选择2006年6月至2007年6月期间来自我院的76例LAM耐药性HBeAg阳性慢性乙型肝炎患者，分别采用ADV及LAM继续治疗。治疗1年后，分别观察两组的血清丙氨酸转氨酶（ALT）、HBeAg、乙肝病毒（HBV）DNA变化情况，并进行安全性分析。结果治疗1年后，两组患者HBeAg转阴率比较，差异无统计学意义（P〉0．05），而ADV组的血清ALT复常率明显高于LAM组，差异有统计学意义（P〈0．05）。ADV组HBVDNA水平明显下降，且显著低于LAM组治疗后HBVDNA水平，差异有统计学意义（P〈0．05）。两组均未见严重不良反应。结论ADV治疗LAM耐药性HBeAg阳性慢性乙型肝炎具有良好的临床疗效及安全性。

Analysis on efficacy and safety of Adefovirdipivoxil therapy for patients with HBeAg(+) chronic hepatitis B resistant to Lamivudine

Objective To observe and analyze the efficacy and safety of adefovirdipivoxil （ADV） therapy for patients with HbeAg （ ＋ ） chronic hepatitis B resistant to lamivudine （LAM）. Methods Seventy six patients with HbeAg （ ＋ ） chronic hepatitis B resistant to LAM were treated with ADV and LAM respectively in this hospital during the period of June, 2006 to June, 2007. Serum levels of ALT, HBeAg and HBV DNA were measured after a therapeutic course of 1 year. Moreover, the adverse events were recorded at the same time. Results There was no sig- nificant difference in sere - conversion rate of HBeAg between these two groups （ P 〉 0.05 ） after a therapeutic course of 1 year, while the rate of normalization of ALT level in ADV group was significantly higher than that of LAM group（ P 〈 0.05 ）. HBV DNA level in ADV group was de- creased and it was significantly lower than that of LAM group （ P 〈 0.05 ）. There was no teratogenesis occurred in patients after ADV and LAM treatment for 1 year. Conclusuon ADV is safe and efficacious in treatment of patients with HBeAg（ ＋ ） chronic hepatitis B resistant to LAM.