实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2013年
4期
308-309
,共2页
慢性乙型肝炎%HBeAg阳性%阿德福韦酯%拉米夫定%治疗
慢性乙型肝炎%HBeAg暘性%阿德福韋酯%拉米伕定%治療
만성을형간염%HBeAg양성%아덕복위지%랍미부정%치료
Hepatitis B%HBeAg positive%Adefovir%Lamivudine%Therapy
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。
目的觀察阿德福韋酯初始治療HBeAg暘性慢性乙型肝炎不應答患者加用拉米伕定治療3年的臨床療效。方法62例HBeAg暘性慢性乙型肝炎患者初始口服國產阿德福韋酯治療，由于未齣現病毒學應答，分彆在治療12週（A組18例）、24週（B組20例）和48週（C組24例）加用拉米伕定繼續治療，觀察3年的療效。結果在治療3年末，A組、B組和C組患者HBV DNA轉陰率分彆為83.3%、60.0%和95.8%，A組和C組療效明顯高于B組（P＜0.05）；ALT複常率分彆為94.4%、100.0%和100.0%，差異無顯著性（P>0.05）；HBeAg轉陰率分彆為66.7%、20.0%和41.7%，A組明顯高于C組和B組；HBeAg血清學轉換率分彆為33.3%、5.0%和8.3%，A組明顯高于B組和C組（P＜0.05）。結論阿德福韋酯初治未齣現病毒學應答的患者可隨時加用拉米伕定聯閤治療。
목적관찰아덕복위지초시치료HBeAg양성만성을형간염불응답환자가용랍미부정치료3년적림상료효。방법62례HBeAg양성만성을형간염환자초시구복국산아덕복위지치료，유우미출현병독학응답，분별재치료12주（A조18례）、24주（B조20례）화48주（C조24례）가용랍미부정계속치료，관찰3년적료효。결과재치료3년말，A조、B조화C조환자HBV DNA전음솔분별위83.3%、60.0%화95.8%，A조화C조료효명현고우B조（P＜0.05）；ALT복상솔분별위94.4%、100.0%화100.0%，차이무현저성（P>0.05）；HBeAg전음솔분별위66.7%、20.0%화41.7%，A조명현고우C조화B조；HBeAg혈청학전환솔분별위33.3%、5.0%화8.3%，A조명현고우B조화C조（P＜0.05）。결론아덕복위지초치미출현병독학응답적환자가수시가용랍미부정연합치료。
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.
