替比夫定联合阿德福韦酯治疗慢性乙型肝炎疗效观察

目的评价替比夫定联合阿德福韦酯治疗慢性乙肝的有效性。方法将84例患者随机分为替比夫定组、阿德福韦酯组、替比夫定联合阿德福韦酯组。观察3组HBeAg／HBeAb血清转换率、HBVDNA转阴率、ALT的变化情况。结果治疗后12周和治疗后24周三组血清HBVDNA、ALT均较治疗前明显降低，差异有显著性意义（P〈0．05）。治疗后12周联合治疗组与阿德福韦酯组血清HBVDNA比较，差异有显著性意义（P〈0．05）。治疗后12周联合治疗组与替比夫定组、阿德福韦酯组ALT比较，差异有显著性意义（P〈0．05）。治疗后24周联合治疗组与阿德福韦酯组HBeAg／HBeAb血清转换率、HBVDNA转阴率比较，差异有显著性意义（P〈0．05）。结论替比夫定与阿德福韦酯联合应用具有更强的抗病毒活性和快速抑制HBV-DNA的能力。两药合用既可以克服病毒对替比夫定的耐药性，又可以提高两药的抗病毒能力。

Observation of curative effect of treating the chronic hepatitis B patients by telbivudine combined with Adefovir dipivoxil

Aim To evaluate the curative effect of treating the Chronic hepatitis B patients by Telbivudine combined with Adefovir dipivoxil. Methods 84 patients were divided into 3 groups at random in order to observe the changes of HBV-DNA, HBeAg/HBeAg serological conversion rate and ALT among three groups. Results After treating 12 and 24 weeks,the level of HBV-DNA and ALT were decreased in comparison with those before treatment （P〈0.05）. After 12 weeks treatment,the level of HBV-DNA and ALT of combination therapy group was better than the Adefovir dipivoxil group＇s that has statistical signficance（P〈0.05）. After ：24 weeks, combination therapy group were better than the Adefovir dipivoxil group in three main outcome measures which has signficant difference. Conclusion There are more powerful antiviral ability of treating CHB patients by Telbivudine combine with Adefovir dipivoxil. The combination therapy can minimize the resistance and increase the anti-viral effect.