CAJ | 학술논문

目的：探讨拉米夫定序贯/联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法选取我院2011年1月~2013年1月收治的慢性乙型肝炎患者79例，随机分为序贯组（40例）和联合组（39例），两组均常规予以保肝治疗，序贯组予以拉米夫定序贯阿德福韦酯进行治疗，联合组予以拉米夫定联合阿德福韦酯进行治疗，比较分析两组的临床疗效。结果联合组用药12个月和24个月时的肝功能指标改善程度显著优于序贯组（P＜0.05）；两组HBeAg、HBV DNA转阴率无明显差异（P＞0.05），HBV DNA定量显著低于序贯组（P＜0.05）；联合组用药12个月、24个月的拉米夫定耐药突变率分别为10.3%、2.6%，显著低于序贯组的35.0%、20.0%（P＜0.05）；两组阿德福韦酯的耐药突变率无明显差异（P＞0.05）。结论拉米夫定联合阿德福韦酯片治疗慢性乙型肝炎具有显著疗效，耐药率低，值得进一步研究应用。
목적：탐토랍미부정서관/연합아덕복위지치료만성을형간염적림상료효。방법선취아원2011년1월~2013년1월수치적만성을형간염환자79례，수궤분위서관조（40례）화연합조（39례），량조균상규여이보간치료，서관조여이랍미부정서관아덕복위지진행치료，연합조여이랍미부정연합아덕복위지진행치료，비교분석량조적림상료효。결과연합조용약12개월화24개월시적간공능지표개선정도현저우우서관조（P＜0.05）；량조HBeAg、HBV DNA전음솔무명현차이（P＞0.05），HBV DNA정량현저저우서관조（P＜0.05）；연합조용약12개월、24개월적랍미부정내약돌변솔분별위10.3%、2.6%，현저저우서관조적35.0%、20.0%（P＜0.05）；량조아덕복위지적내약돌변솔무명현차이（P＞0.05）。결론랍미부정연합아덕복위지편치료만성을형간염구유현저료효，내약솔저，치득진일보연구응용。
Objective To investigate the clinical efficacy of lamivudine and adefovir sequential or combined in treatment of chronic hepatitis B.Methods 79 patients with chronic hepatitis B in our hospital between January 2011 and January 2013 were randomly divided into sequential group (40 cases) and the combination group (39 cases), both groups were received routine liver treatment.the sequential group received lamivudine adefovir sequential treatment, the combination group received lamivudine combined adefovir treatment. The clinical efficacy of the two groups was comparative analysised.ResultsThe degree of improvement in liver function in combination group for 12 months and 24 months were significantly better than the sequential group (P<0.05); HBeAg abd HBV DNA negative rate in two groups was no significant difference (P>0.05), HBV DNA quantification was significantly lower than the sequential group (P<0.05); combined group treatment for 12 months, the rate of lamivudine resistance mutations 24 months was 10.3%, 2.6%, respectively, significantly lower than the 35.0% sequential group, 20.0% (P<0.05); resistant mutation rate of adefovir dipivoxil groups had no significant difference (P>0.05).ConclusionLamivudine combined with adefovir dipivoxil tablets in the treatment of chronic hepatitis B have a significant effect and low resistance, it's worthy of further research.