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目的探讨恩替卡韦联合拉米夫定较单用拉米夫定治疗慢性乙型肝炎的疗效。方法将河北医科大学第一医院156例在治疗前未检测出HBV-YMDD变异并且HBV-DNA均为阳性的慢性乙肝患者随机分为研究组和对照组。其中,研究组采用拉米夫定全程联合恩替卡韦治疗;对照组则单用拉米夫定进行治疗,两组疗程均为12个月。在各组治疗第3个月、第6个月、第9个月、第12个月时分别检测血清HBV-YMDD变异情况与HBV-DNA水平的变化。结果与对照组相比,在第3个月、第6个月、第9个月、第12个月,研究组中患者检出HBV-YMDD变异例数少、HBVDNA阴转率高,两组变异率差别具有统计学意义(P<0.05),两组阴转率差别具有统计学意义(P<0.05)。结论恩替卡韦联合拉米夫定较单用拉米夫定治疗慢性乙型肝炎对患者更安全更有疗效,值得推广应用。
Objective To investigate the curative effect of entecavir combined with lamivudine in the treatment of chronic hepatitis B with lamivudine alone. Methods A total of 156 CHB patients without HBV-YMDD mutation and HBV-DNA positive HBV DNA before treatment were randomly divided into study group and control group. Among them, the study group treated with lamivudine full entecavir treatment; the control group was treated with lamivudine alone, two courses of treatment were 12 months. The variation of serum HBV-YMDD and the level of HBV-DNA were detected at the third month, the sixth month, the ninth month and the twelfth month in each group. Results Compared with the control group, in the third month, the sixth month, the ninth month and the twelfth month, there were fewer cases of HBV-YMDD mutation in the study group and the negative rate of HBVDNA was higher in the two groups The difference of mutation rate was statistically significant (P <0.05), and the difference of negative conversion rate between the two groups was statistically significant (P <0.05). Conclusion Entecavir combined with lamivudine than lamivudine alone treatment of chronic hepatitis B patients safer and more effective, it is worth promoting the application.