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目的:评价阿德福韦酯对拉米夫定耐药的慢性乙型肝炎(CHB)患者的疗效及其对肝功能和HBV-DNA水平的影响。方法:选取2014年1月—2016年5月期间收治的对拉米夫定产生耐药性的CHB患者60例作为研究对象,采取计算机随机数字分组法将其分为对照组和观察组,每组30例;对照组患者给予阿德福韦酯治疗,观察组患者给予阿德福韦酯与拉米夫定联用治疗,比较两组治疗后HBV-DNA和HBeAg转阴率的差异,以及治疗前后对肝功能各指标的改善情况。结果:观察组患者治疗后HBV-DNA和HBeAg转阴率分别为83.33%和70.00%均高于对照组为56.67%和43.33%(P<0.05);两组患者治疗后的HBV-DNA定量、ALT、AST、总胆红素水平测得值均低于治疗前(P<0.05);而治疗后观察组患者各项指标测得值均低于对照组(P<0.05),慢性肝病症状的评分值均明显高于对照组(P<0.05)。结论:对拉米夫定耐药CHB患者,采用拉米夫定与阿德福韦酯治疗,可有效提高抗乙肝病毒治疗效果,有利于改善患者肝功能及其对身心健康的影响。
Objective: To evaluate the effect of adefovir dipivoxil on lamivudine-resistant chronic hepatitis B (CHB) patients and its effect on liver function and HBV-DNA levels. Methods: From January 2014 to May 2016, 60 patients with CHB resistant to lamivudine were enrolled in this study. Patients were divided into control group and observation group by random number grouping method 30 patients in the control group were treated with adefovir dipivoxil and the observation group was treated with adefovir dipivoxil combined with lamivudine to compare the difference of HBV DNA and HBeAg negative rates after treatment Before and after treatment of liver function improvement of the indicators. Results: After treatment, the negative rates of HBV DNA and HBeAg in the observation group were 83.33% and 70.00%, respectively, which were 56.67% and 43.33% higher than those in the control group (P <0.05). The HBV-DNA, ALT, AST, total bilirubin levels were lower than before treatment (P <0.05); while after treatment, the measured values of various indicators of the observation group were lower than the control group (P <0.05), the symptoms of chronic liver disease Scores were significantly higher than the control group (P <0.05). Conclusion: Lamivudine and adefovir dipivoxil treatment can effectively improve the anti-hepatitis B virus treatment effect in patients with lamivudine-resistant CHB, which is beneficial to improve liver function and mental and physical health of patients.