医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2012年
31期
11-13
,共3页
拉米夫定%阿德福韦酯%恩替卡韦%慢性乙型肝炎
拉米伕定%阿德福韋酯%恩替卡韋%慢性乙型肝炎
랍미부정%아덕복위지%은체잡위%만성을형간염
Lamivudine%Adefovir Dipivoxil%Entecavir%Chronic hepatitis B
目的比较拉米夫定和阿德福韦酯初始联合与恩替卡韦单药治疗慢性乙型肝炎的疗效,为慢性乙型肝炎患者提供合理治疗方案.方法选择我院2010年7月~2011年9月符合抗病毒治疗的未曾使用过核苷(酸)类似物的初治慢性乙型肝炎患者80例,分为联合组40例,单药组40例,联合组用拉米夫定100mg,阿德福韦酯10mg,1次/日;单药组用恩替卡韦0.5mg,1次/日,均口服.分别在基线、12、24、48、72周时留取血清,检测相关指标并进行比较.
结果联合组36例,单药组34例完成了72周随访,两组患者治疗前性别、年龄、血清ALT、胆红素、HBV DNA、HBeAg阳性率、血肌酐比较差异均无统计学意义(P>0.05);在治疗不同时间联合组和单药组生化应答比例及与基线比较两组HBV DNA下降绝对值差异均无统计学意义(P>0.05);联合组和单药组在治疗12、24、48周时HBV DNA<500拷贝/ml的比率、HBeAg血清转换率,差异均无统计学意义(P>0.05);但是在治疗72周时HBV DNA<500拷贝/ml的患者比率及HBeAg血清转换率联合组分别为88.9%、30.4%,单药组分别76.5%、12.5%,两组比较差异有统计学意义(P均<0.05);两组患者治疗期间未发现病毒变异及耐药发生,未发现与用药相关的肾功能损伤等严重不良反应,耐受性均良好.结论初始联合LAM及ADV在抑制病毒复制、提高HBeAg血清转换率方面优于恩替卡韦单药治疗,两种治疗方法的安全性无显著差异.
目的比較拉米伕定和阿德福韋酯初始聯閤與恩替卡韋單藥治療慢性乙型肝炎的療效,為慢性乙型肝炎患者提供閤理治療方案.方法選擇我院2010年7月~2011年9月符閤抗病毒治療的未曾使用過覈苷(痠)類似物的初治慢性乙型肝炎患者80例,分為聯閤組40例,單藥組40例,聯閤組用拉米伕定100mg,阿德福韋酯10mg,1次/日;單藥組用恩替卡韋0.5mg,1次/日,均口服.分彆在基線、12、24、48、72週時留取血清,檢測相關指標併進行比較.
結果聯閤組36例,單藥組34例完成瞭72週隨訪,兩組患者治療前性彆、年齡、血清ALT、膽紅素、HBV DNA、HBeAg暘性率、血肌酐比較差異均無統計學意義(P>0.05);在治療不同時間聯閤組和單藥組生化應答比例及與基線比較兩組HBV DNA下降絕對值差異均無統計學意義(P>0.05);聯閤組和單藥組在治療12、24、48週時HBV DNA<500拷貝/ml的比率、HBeAg血清轉換率,差異均無統計學意義(P>0.05);但是在治療72週時HBV DNA<500拷貝/ml的患者比率及HBeAg血清轉換率聯閤組分彆為88.9%、30.4%,單藥組分彆76.5%、12.5%,兩組比較差異有統計學意義(P均<0.05);兩組患者治療期間未髮現病毒變異及耐藥髮生,未髮現與用藥相關的腎功能損傷等嚴重不良反應,耐受性均良好.結論初始聯閤LAM及ADV在抑製病毒複製、提高HBeAg血清轉換率方麵優于恩替卡韋單藥治療,兩種治療方法的安全性無顯著差異.
목적비교랍미부정화아덕복위지초시연합여은체잡위단약치료만성을형간염적료효,위만성을형간염환자제공합리치료방안.방법선택아원2010년7월~2011년9월부합항병독치료적미증사용과핵감(산)유사물적초치만성을형간염환자80례,분위연합조40례,단약조40례,연합조용랍미부정100mg,아덕복위지10mg,1차/일;단약조용은체잡위0.5mg,1차/일,균구복.분별재기선、12、24、48、72주시류취혈청,검측상관지표병진행비교.
결과연합조36례,단약조34례완성료72주수방,량조환자치료전성별、년령、혈청ALT、담홍소、HBV DNA、HBeAg양성솔、혈기항비교차이균무통계학의의(P>0.05);재치료불동시간연합조화단약조생화응답비례급여기선비교량조HBV DNA하강절대치차이균무통계학의의(P>0.05);연합조화단약조재치료12、24、48주시HBV DNA<500고패/ml적비솔、HBeAg혈청전환솔,차이균무통계학의의(P>0.05);단시재치료72주시HBV DNA<500고패/ml적환자비솔급HBeAg혈청전환솔연합조분별위88.9%、30.4%,단약조분별76.5%、12.5%,량조비교차이유통계학의의(P균<0.05);량조환자치료기간미발현병독변이급내약발생,미발현여용약상관적신공능손상등엄중불량반응,내수성균량호.결론초시연합LAM급ADV재억제병독복제、제고HBeAg혈청전환솔방면우우은체잡위단약치료,량충치료방법적안전성무현저차이.
ObjectiveTO compare the efficacy of Lamivudine plus Adefovir dipivoxil combination therapy and Entecavir monotherapy for chronic hepatitis B patients,so as to provide chronic hepatitis B patients with appropriate treatment. Methods80 patients with chronic hepatitis B managed in a single-centre clinical practice were split into 2 cohorts.one was treated with de-novo combiniation Lamivudine (100mg/day) plus Adefovir(10mg/day),the other with Entecavir(0.5mg/day)monotherapy.Serum levels of related index were analyzed at 0,12,24,48,72 weeks,respectively.ResultsAt the tinme point of 72 weeks,a total of 70 patients(36 cases in combination therapy cohort and 34 cases in monotherapy cohort)were compared.The baseline characteristics as for age,gender,HBV viral load,HBeAg seroconversion, etcetera were compatible between these two cohorts(P>0.05);The ALT normaLization and the mean values of decreases for HBV viral loads were smilar in both cohorts in the treatment of different time;The rates of HBV DNA<500 copies/ml and HBeAg seroconversion had no significant between the two cohorts by the 12,24 and 48 weeks(P>0.05);At the time point of 72 weeks,the rates of HBV DNA<500 copies/ml(88.9%vs76.5%)and the HBeAg seroconve-rsion(30.4%vs12.5%)were markedly higher in combination therapy cohort than those of monotherapy cohort statisticaly (P<0.05 for al);No mutation of the virus and drug resistance occurred in both cohorts during the treatment,and not found the drug related kidney damage and other serious adverse reaction,the tolerance are good.ConclusionsPresent study suggests that Lamivudine plus Adefovir denovo Combination therapy was more efficacious than Entecavir monotherapy for chronic hepatitis B patients,and the safety between the two cohorts had no significant .
