中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2014年
4期
320-323
,共4页
恩替卡韦%阿德福韦酯%肝炎,乙型,慢性%拉米夫定%抗药性,病毒
恩替卡韋%阿德福韋酯%肝炎,乙型,慢性%拉米伕定%抗藥性,病毒
은체잡위%아덕복위지%간염,을형,만성%랍미부정%항약성,병독
Entecavir%Adefovir dipivoxil%Hepatitis B,chronic%Lamivudine%Drug resistance,viral
目的 探讨恩替卡韦(ETV)联合阿德福韦酯(ADV)治疗拉米夫定耐药的慢性乙型肝炎(CHB)的疗效.方法 以2012年4月至2013年4月本院收治的拉米夫定耐药的CHB患者90例为研究对象,按随机数字表法分为ETV联合ADV治疗组(A组,n=48)和ETV治疗组(B组,n=42).B组患者口服ETV(0.5 mg/d),每天1次;A组患者在此基础上,联合应用ADV口服(10 mg/d),每天1次,均持续用药48周.治疗前及治疗后12、24、48周检测HBV血清学标志物、血清HBV DNA、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST) 、IL-10水平,计算生物化学应答率、病毒学应答率、HBeAg转阴率、HBeAg血清学转换率.结果 治疗后12、24、48周,两组患者HBVDNA及ALT水平均显著下降(均P<0.05),且上述各时点A组HBV DNA及ALT水平均显著低于B组(均P<0.05).治疗后24、48周,A组的生物化学应答率、病毒学应答率均显著高于B组(均P< 0.05),但HBeAg转阴率及HBeAg血清学转换率差异无统计学意义(均P> 0.05).治疗后12、24、48周,A组IL-10水平均显著低于B组(均P<0.05).结论 ETV联合ADV治疗拉米夫定耐药的CHB患者中期治疗效果较好.
目的 探討恩替卡韋(ETV)聯閤阿德福韋酯(ADV)治療拉米伕定耐藥的慢性乙型肝炎(CHB)的療效.方法 以2012年4月至2013年4月本院收治的拉米伕定耐藥的CHB患者90例為研究對象,按隨機數字錶法分為ETV聯閤ADV治療組(A組,n=48)和ETV治療組(B組,n=42).B組患者口服ETV(0.5 mg/d),每天1次;A組患者在此基礎上,聯閤應用ADV口服(10 mg/d),每天1次,均持續用藥48週.治療前及治療後12、24、48週檢測HBV血清學標誌物、血清HBV DNA、丙氨痠氨基轉移酶(ALT)、天門鼕氨痠氨基轉移酶(AST) 、IL-10水平,計算生物化學應答率、病毒學應答率、HBeAg轉陰率、HBeAg血清學轉換率.結果 治療後12、24、48週,兩組患者HBVDNA及ALT水平均顯著下降(均P<0.05),且上述各時點A組HBV DNA及ALT水平均顯著低于B組(均P<0.05).治療後24、48週,A組的生物化學應答率、病毒學應答率均顯著高于B組(均P< 0.05),但HBeAg轉陰率及HBeAg血清學轉換率差異無統計學意義(均P> 0.05).治療後12、24、48週,A組IL-10水平均顯著低于B組(均P<0.05).結論 ETV聯閤ADV治療拉米伕定耐藥的CHB患者中期治療效果較好.
목적 탐토은체잡위(ETV)연합아덕복위지(ADV)치료랍미부정내약적만성을형간염(CHB)적료효.방법 이2012년4월지2013년4월본원수치적랍미부정내약적CHB환자90례위연구대상,안수궤수자표법분위ETV연합ADV치료조(A조,n=48)화ETV치료조(B조,n=42).B조환자구복ETV(0.5 mg/d),매천1차;A조환자재차기출상,연합응용ADV구복(10 mg/d),매천1차,균지속용약48주.치료전급치료후12、24、48주검측HBV혈청학표지물、혈청HBV DNA、병안산안기전이매(ALT)、천문동안산안기전이매(AST) 、IL-10수평,계산생물화학응답솔、병독학응답솔、HBeAg전음솔、HBeAg혈청학전환솔.결과 치료후12、24、48주,량조환자HBVDNA급ALT수평균현저하강(균P<0.05),차상술각시점A조HBV DNA급ALT수평균현저저우B조(균P<0.05).치료후24、48주,A조적생물화학응답솔、병독학응답솔균현저고우B조(균P< 0.05),단HBeAg전음솔급HBeAg혈청학전환솔차이무통계학의의(균P> 0.05).치료후12、24、48주,A조IL-10수평균현저저우B조(균P<0.05).결론 ETV연합ADV치료랍미부정내약적CHB환자중기치료효과교호.
Objective To investigate the efficacy of entecavir (ETV) combined with adefovir dipivoxil (ADV) in the treatment of patients with lamivudine-resistant chronic hepatitis B (CHB).Methods Ninety lamivudine-resistant CHB patients admitted in our hospital from April 2012 to April 2013 were selected,and randomly divided into ETV combined with ADV treatment group (group A,n=48) and ETV treatment group (group B,n=42).Patients in group B took ETV orally (0.5 mg/d) once per day for 48 successive weeks,and patients in group A took ADV orally (10 mg/d) once per day on the basis of the treatment of group B for 48 successive weeks also.The HBV serologic indicator,serum HBV DNA,alanine aminotransferase (ALT),aspartate aminotransferase (AST),IL-10 level were detected before treatment and 12,24 and 48 weeks after treatment,respectively.The biochemical response rate,virological response rate,HBeAg negative conversion rate,HBeAg serological conversion rate were calculated.Results The levels of HBV DNA and ALT in both groups decreased significantly 12,24 and 48 weeks after treatment (all P<0.05),and the levels of HBV DNA and ALT in group A were significantly lower than those in group B at each above time points (all P<0.05).The biochemical response rate,virological response rate in group A were significantly higher than those in group B 24 and 48 weeks after treatment (all P<0.05),while there was no statistical significance of HBeAg negative conversion rate and HBeAg serological conversion rate between two groups (all P>0.05).The serum IL-10 level in group A was significantly lower than those in group B 12,24 and 48 weeks after treatment (all P<0.05).Conclusion ETV combined with ADV has better efficacy in the middle stage of the treatment for lamivudine-resistant CHB patients.