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目的观察阿德福韦酯治疗慢性乙型肝炎患者的临床疗效及乙型肝炎病毒标记物的变化。方法选取2004年2～4月中国医科大学附属盛京医院感染科门诊慢性乙型肝炎患者35例,口服阿德福韦酯10mg,每日1次,连续服用48周。观察血清丙氨酸转氨酶复常率、乙型肝炎病毒(HBV-DNA)阴转率、HBeAg阴转率和HBeAg血清转换率。结果患者在治疗第4周血清丙氨酸转氨酶(ALT)复常率低(2.86%),HBV-DNA及HBeAg血清学没有明显的变化。而在24周ALT复常率(51.42%)和HBV-DNA阴转率(40%)明显升高,HBeAg血清转换率达8.57%。当治疗至48周时,ALT复常率80%,HBV-DNA的阴转率48.57%,而HBeAg血清转换率高达17.14%。结论阿德福韦酯治疗慢性乙型肝炎患者,起效较慢,但可以明显改善肝脏炎症,对HBV起到抑制作用,是很有效的抗病毒新药。
Objective To observe the clinical efficacy of adefovir dipivoxil in the treatment of patients with chronic hepatitis B and the changes of hepatitis B virus markers. Methods From February to April 2004, 35 patients with chronic hepatitis B from outpatient department of Shengjing Hospital affiliated to China Medical University were enrolled. Adefovir dipivoxil 10 mg was given once daily for 48 weeks. Serum alanine aminotransferase normalization rate, hepatitis B virus (HBV-DNA) negative conversion rate, HBeAg negative conversion rate and HBeAg seroconversion rate were observed. Results In the fourth week of treatment, the serum alanine aminotransferase (ALT) recovery rate was low (2.86%) in patients with no obvious change of HBV-DNA and HBeAg serology. ALT normalization rate (51.42%) and HBV-DNA negative conversion rate (40%) were significantly higher at 24 weeks, and HBeAg seroconversion rate reached 8.57%. When treated for 48 weeks, the ALT normalization rate was 80%, the HBV-DNA negative conversion rate was 48.57%, and the HBeAg seroconversion rate was as high as 17.14%. Conclusion adefovir dipivoxil treatment of chronic hepatitis B patients with slower onset, but can significantly improve liver inflammation, HBV has an inhibitory effect, is a very effective anti-virus drug.