摘要
目的观察阿德福韦酯初始治疗HBeAg阳性慢性乙型肝炎不应答患者加用拉米夫定治疗3年的临床疗效。方法 62例HBeAg阳性慢性乙型肝炎患者初始口服国产阿德福韦酯治疗,由于未出现病毒学应答,分别在治疗12周(A组18例)、24周(B组20例)和48周(C组24例)加用拉米夫定继续治疗,观察3年的疗效。结果在治疗3年末,A组、B组和C组患者HBV DNA转阴率分别为83.3%、60.0%和95.8%,A组和C组疗效明显高于B组(P<0.05);ALT复常率分别为94.4%、100.0%和100.0%,差异无显著性(P>0.05);HBeAg转阴率分别为66.7%、20.0%和41.7%,A组明显高于C组和B组;HBeAg血清学转换率分别为33.3%、5.0%和8.3%,A组明显高于B组和C组(P<0.05)。结论阿德福韦酯初治未出现病毒学应答的患者可随时加用拉米夫定联合治疗。
Objective To investigate the clinical efficacy of combination of adefovir and lamivudine in treatment of patients with HBeAg positive hepatitis B who failed to adefovir therapy. Methods Sixty-two HBeAg positive patients with chronic hepatitis B（CHB）took adefovir at dose of 10 mg daily as initial treatment. They had adefovir and lamivudine combination therapy after 12 weeks（n=18 in group A）,24 weeks（n=20 in group B） and 48 weeks （n=24 in group C）,respectively,as they had not virological response. All patients were followed-up for three years. Results At the end of three years,the serum HBV DNA loss in group A,group B and group C were 83.3%,60.0% and 95.8%（P〈0.05）,respectively;ALT normalization rates were 94.4%,100.0% and 100.0%（P〉0.05）,respectively;serum HBeAg negativity rates were 66.7%,20.0% and 41.7%,respectively;and HBeAg serocon-version rates were 33.3%,5.0% and 8.3%,respectively（P〈0.05）. Conclusion Combination of adefovir and lamivu-dine is appropriate to patients with CHB who failed to adefovir treatment.
出处
《实用肝脏病杂志》
CAS
2013年第4期308-309,共2页
Journal of Practical Hepatology
