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目的观察阿德福韦酯初治与拉米夫定治疗耐药后联合阿德福韦酯治疗慢性乙型肝炎患者的疗效。方法将45例入选患者分为两组,其中A组为拉米夫定治疗耐药后加用阿德福韦酯治疗组,B组为阿德福韦酯初治组。治疗前及治疗后12、24、36、48周均检测肝功能、肾功能、HBV DNA载量。结果在治疗12、24周时,A组患者的HBV DNA低于检测下限的比率明显高于B组,差异有统计学意义;治疗48周时,两组HBV DNA载量变化、低于检测下限的比率、ALT复常率的差异均无统计学意义。在治疗期间两组患者的肾功能均正常,均未发现不良反应。结论阿德福韦酯初治与联合拉米夫定治疗拉米夫定耐药后慢性乙型肝炎患者同样有效,值得继续探索。
Objective To observe the curative effect of adefovir dipivoxil and lamivudine combined with adefovir dipivoxil in the treatment of chronic hepatitis B patients. Methods Forty-five patients were divided into two groups. Group A was treated with lamivudine plus adefovir dipivoxil-resistant group and group B was adefovir dipivoxil-treated group. Before treatment and 12, 24, 36, 48 weeks after treatment, liver function, renal function and HBV DNA load were detected. Results At 12 and 24 weeks of treatment, the HBV DNA level in group A was significantly lower than that in group B, and the difference was statistically significant. At 48 weeks, the HBV DNA load in both groups was lower than the detection limit The rate of ALT normalization rate differences were not statistically significant. During the treatment of renal function in both groups were normal, no adverse reactions were found. Conclusions Both adefovir dipivoxil and lamivudine are equally effective in treating patients with chronic hepatitis B after lamivudine resistance.