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目的:观察拉米夫定联合阿德福韦酯治疗E抗原阴性的慢性乙型肝炎患者的疗效和安全性。方法:2006～2007年来我院就诊的慢性乙型肝炎患者,给予拉米夫定100mg/d,阿德福韦酯100mg/d,观察治疗前及治疗后12、24及48周谷丙转氨酶水平、HBV DNA水平、乙型肝炎病毒血清标志物的应答效果及肾功能变化。结果:治疗12周、24周和48周时,HBV DNA转阴率分别为17%、43%和87%,且各组间差异具有统计学意义(P<0.05);ALT复常率分别为13%,67%和100%,且各组间差异具有统计学意义(P<0.05);治疗48周时,所有患者均未发生表面抗原的消失;整个治疗过程中,患者的耐受性良好,未发生一例严重不良事件。结论:拉米夫定联合阿德福韦酯治疗E抗原阴性的慢性乙肝患者,可获得较好的临床疗效,该治疗策略为临床抗病毒治疗提供了新的选择。
Objective: To observe the efficacy and safety of lamivudine combined with adefovir dipivoxil in the treatment of E antigen negative chronic hepatitis B patients. Methods: Patients with chronic hepatitis B treated in our hospital from 2006 to 2007 were given lamivudine 100 mg / d and adefovir dipivoxil 100 mg / d. The levels of alanine aminotransferase (ALT) before and after treatment were observed at 12, 24 and 48 weeks , HBV DNA levels, the response of hepatitis B virus serum markers and renal function changes. Results: At 12 weeks, 24 weeks and 48 weeks after treatment, the negative rates of HBV DNA were 17%, 43% and 87%, respectively, with significant difference (P <0.05). The rates of ALT abnormalities were 13%, 67%, and 100%, respectively, and there was significant difference between the groups (P <0.05). No antigen disappeared in all patients at 48 weeks of treatment. The patients were well tolerated throughout the course of treatment No serious adverse event occurred. Conclusion: Lamivudine combined with adefovir dipivoxil treatment of E antigen-negative chronic hepatitis B patients can obtain better clinical efficacy, the treatment strategy for the clinical anti-viral treatment provides a new choice.