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目的观察阿德福韦酯联合干扰素治疗HBeAg阳性慢性乙型肝炎疗效。方法将安微省铜陵市有色职工总医院60例经干扰素α抗病毒应答不佳HBeAg阳性慢性乙型肝炎患者随机分为联合组(n=32)和对照组(n=28)。联合组给予,阿德福韦酯10mg口服,1次/d,继用干扰素α500万单位隔天1次肌肉注射;对照组给予拉米夫定100mg口服,1次/d,2组治疗观察均为12个月。结果治疗6、12个月时治疗组ALT复常率分别为50%和96.9%。HBeAg/抗HBe血清转换率分别为43.7%和87.5%,HBV-DNA转阴率分别为53.1%和87.5%;对照组治疗6、12个月时,ALT复常率分别为39.3%和50.0%,HBeAg/抗HBe血清转换率分别为32.1%和46.4%,HBV-DNA转阴率分别为39.3%和、46.4%。2组治疗6个月时ALT复常率,HBeAg/抗HBe血清转换率,HBV-DNA转阴率比较,差异无统计学意义;12个月时2组比较,差异有统计学意义(P<0.05)。结论阿德福韦酯与干扰素α联合治疗HBeAg阳性乙型肝炎疗效优于拉米夫定单一用药。
Objective To observe the efficacy of adefovir dipivoxil combined with interferon in the treatment of HBeAg-positive chronic hepatitis B patients. Methods Sixty patients with HBeAg-positive chronic hepatitis B who had poor response to interferon α antiviral therapy were randomly divided into combined group (n = 32) and control group (n = 28). The combination group given, adefovir dipivoxil 10mg orally, once / d, followed by interferon α 500 million units once a day intramuscularly; control group given lamivudine 100mg orally, 1 / d, 2 groups of treatment All 12 months. Results At 6 and 12 months, the ALT normalization rates in the treatment group were 50% and 96.9%, respectively. HBeAg / anti-HBe seroconversion rates were 43.7% and 87.5%, HBV-DNA negative rates were 53.1% and 87.5%; control group 6,12 months, ALT normalization rates were 39.3% and 50.0% , HBeAg / anti-HBe seroconversion rates were 32.1% and 46.4%, HBV-DNA negative rates were 39.3% and 46.4%, respectively. There was no significant difference in ALT normalization rate, HBeAg / anti-HBe seroconversion rate and HBV-DNA negative conversion rate between the two groups at 6 months. There was significant difference between the two groups at 12 months (P < 0.05). Conclusion Adefovir dipivoxil combined with interferon α treatment HBeAg-positive hepatitis B is better than lamivudine single-agent treatment.