CAJ | 학술논문

目的：观察初始拉米夫定（LAM）和阿德福韦酯（ADV）联合与 LAM、恩替卡韦（ETV）单药治疗基因B／C型HBeAg （＋）慢性乙型肝炎（慢乙肝）患者的疗效。方法：招募182例符合中国慢乙肝防治指南中治疗标准的基因 B／C 型 HBeAg （＋）慢乙肝初始治疗患者，随机分为3组，分别以 LAM 和 ADV 联合、LAM 或ETV单药治疗48周，观察疗效。结果：基线水平无差异的3组患者分别经过3种方案治疗后，联合治疗组生化学应答率（12周P ＜0．01，24周P ＜0．01，48周P ＜0．01）、HBeAg 血清学应答率（12周P ＜0．01，24周P ＜0．05，48周P ＜0．05）、完全病毒学应答率（12周 P ＜0．05，24周 P ＜0．05，48周 P ＜0．05）均高于 LAM组。联合治疗组在生化学应答方面较ETV组存在一定优势。结论：LAM和ADV初始联合治疗是我国以B／C型基因为主的慢乙肝患者抗病毒治疗的优良策略。
목적：관찰초시랍미부정（LAM）화아덕복위지（ADV）연합여 LAM、은체잡위（ETV）단약치료기인B／C형HBeAg （＋）만성을형간염（만을간）환자적료효。방법：초모182례부합중국만을간방치지남중치료표준적기인 B／C 형 HBeAg （＋）만을간초시치료환자，수궤분위3조，분별이 LAM 화 ADV 연합、LAM 혹ETV단약치료48주，관찰료효。결과：기선수평무차이적3조환자분별경과3충방안치료후，연합치료조생화학응답솔（12주P ＜0．01，24주P ＜0．01，48주P ＜0．01）、HBeAg 혈청학응답솔（12주P ＜0．01，24주P ＜0．05，48주P ＜0．05）、완전병독학응답솔（12주 P ＜0．05，24주 P ＜0．05，48주 P ＜0．05）균고우 LAM조。연합치료조재생화학응답방면교ETV조존재일정우세。결론：LAM화ADV초시연합치료시아국이B／C형기인위주적만을간환자항병독치료적우량책략。
Objective To observe the efficacy of de novo combination therapy lamivudine plus adefovir , lamivudine monotherapy and entecavir monotherapy in HBeAg-positive CHB patients with genotype B/C. Methods A total of 182 treatment-naive CHB patients in line with treatment standards of Chinese CHB prevention and treatment guidelines were randomly assigned to three groups and treated with lamivudine plus adefovir or lamivudine monotherapy or entecavir monotherapy for 48 weeks. Results Patients in three groups presented no difference in baseline levels. After treatment by three therapies , the group of lamivudine plus adefovir showed a higher biochemical response rates (12 week P < 0.01, 24 week P < 0.01, 48 week P < 0.01), HBeAg-serological rates(12 week P < 0.01, 24 week P < 0.05, 48 week P < 0.05) and completely virological response rates (12 week P < 0.05, 24 week P < 0.05, 48 week P < 0.05) than lamivudine group. In terms of biochemical response rates , the group of lamivudine plus adefovir had certain advantages when compared with entecavir group. Conclusion De novo combination therapy lamivudine plus adefovir is a good antiviral strategy for chronic hepatitis B patients with B/C genotype viral infection in China.