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目的观察恩替卡韦联合阿德福韦酯治疗HBeAg阴性慢性乙型肝炎患者的疗效。方法未经抗病毒治疗的HBeAg阴性慢性乙型肝炎患者200例,随机均分为两组:对照组给予恩替卡韦0.5mg/d口服治疗;观察组加用阿德福韦酯10mg/d口服治疗。治疗3个月后,比较两组T细胞亚群、HBV DNA、ALT、AST和TBil水平,记录不良反应发生情况。结果两组治疗后,ALT、AST、TBil、HBV DNA水平均低于治疗前(P<0.05),观察组治疗后AST、TBil、HBV DNA水平低于对照组(P<0.05)。治疗后,观察组外周血CD4+细胞比率和CD4~+/CD8~+均高于对照组,CD8~+细胞比率低于对照组(P<0.05)。治疗3个月,观察组总有效率高于对照组(98.0%vs.82.0%)(P<0.05),两组不良反应发生率差异无统计学意义(P>0.05)。结论与单用恩替卡韦比较,恩替卡韦联合阿德福韦酯治疗HBeAg阴性慢性乙型肝炎患者更能改善患者细胞免疫功能,提高临床疗效,且不增加不良反应的发生率。
Objective To observe the curative effect of entecavir and adefovir dipivoxil on HBeAg-negative chronic hepatitis B patients. Methods 200 cases of HBeAg-negative chronic hepatitis B patients without antiviral therapy were randomly divided into two groups: the control group was treated with entecavir 0.5 mg / d orally; the observation group plus adefovir dipivoxil 10 mg / d orally. Three months after treatment, T cell subsets, HBV DNA, ALT, AST and TBil levels were compared between the two groups, and the incidence of adverse reactions was recorded. Results After treatment, the levels of ALT, AST, TBil and HBV DNA were lower than those before treatment (P <0.05). The levels of AST, TBil and HBV DNA in the observation group were lower than those in the control group after treatment (P <0.05). After treatment, the percentage of CD4 + cells and CD4 + / CD8 + in the peripheral blood of the observation group were higher than that of the control group, and the ratio of CD8 + cells in the observation group was lower than that in the control group (P <0.05). After 3 months of treatment, the total effective rate in the observation group was higher than that in the control group (98.0% vs.82.0%) (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Entecavir combined with adefovir dipivoxil treatment of patients with HBeAg-negative chronic hepatitis B can improve cellular immune function, improve clinical efficacy, and does not increase the incidence of adverse reactions.