摘要
目的探讨联合使用阿德福韦酯与拉米夫定在乙型肝炎肝硬化失代偿期病人中抗病毒治疗的安全性与疗效,从而寻找更加有效的治疗方法。方法应用前瞻性随机分组的方法,对64例乙型肝炎肝硬化失代偿期患者随机分成两组。A组予阿德福韦酯(10mg/d)联合拉米夫定(100mg/d)治疗;B组予阿德福韦酯(10mg/d)治疗;直至治疗结束。以上两组的疗程均为48周,分别在治疗的12、24、36和48周抽血,检测各组血清ALT、HBeAg、HBV DNA及child分级变化。结果治疗结束后,两组患者HBV DNA阴转率为87.1%及78.8%,有效率分别为96.8%及87.9%;HBeAg阴转率分别为83.9%及57.6%;HBeAg/抗-HBe血清转换率分别为41.9%及24.2%;血清ALT复常率分别为96.8%及97.0%。结论联合用药可减少耐药的发生,并可增加抗病毒效果,且其安全性良好,但需扩大样本进一步研究。
ObjectiveTo assess the therapeutic effectiveness of monotherapy of adefovir dipivoxil （ADV） and lamivudine （LAM）, or ADV administered in combination with LAM, in order to find the effective and secure therapy for decompensated cirrhosis patients following chronic hepatitis B. MethodsTotally 64 decompensated cirrhosis patients following chronic hepatitis B were divided into 2 groups by using a prospective randomized grouping method. In group A, patients received the therapy of adefovir dipivoxil （10mg/d） combined with lamivudine （100mg/d）; and in group B, a monotherapy of adefovir dipivoxil （10mg/d） was used. The period of treatment was 48 weeks. Levels of serum ALT, HBeAg and HBV-DNA were detected in week 12,24,36 and 48 respectively. The liver function was evaluated with Child scores on these time points. Data were analyzed by a blinded independent investigator. ResultsAfter 48 weeks treatment, HBV DNA negative conversion rate of the two groups were 87.1%and 78.8%.The virtual rate were 96.8% and 87.9%;HBeAg negative conversion rate were 83.9%,and 57.6%. HBeAg/anti- HBe seroconversion rates of the two groups were 41.9%and 24.2%. Normalization of serum ALT levels were observed in 96.8% patients of group A and 97.0% of group B. ConclusionThe combination therapy of adefovir dipivoxil （ADV） and lamivudine （LAM） could reduce the occurrence of drug resistance, and increase the anti-viral effect. It is a secure management for chronic hepatitis B virus infection.
出处
《医学研究杂志》
2010年第1期40-42,共3页
Journal of Medical Research
基金
军队"十一五"中医药研发推广专项重大临床攻关课题(2006231001)
关键词
肝硬化
乙型
失代偿
拉米夫定
阿德福韦酯
Cirrhosis
Type B
Decompensation
Lamivudine
Adefovir dipivoxil
