拉米夫定联合阿德福韦治疗慢性乙型肝炎患者临床疗效与预后观察
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摘要
目的探讨拉米夫定联合阿德福韦治疗慢性乙型肝炎(HBV)的临床疗效,并观察和分析其预后,以改善肝功能。方法选取2011年6月-2014年6月慢性乙型肝炎患者126例,随机分为对照组和观察组,两组各63例,对照组患者应用阿德福韦治疗,观察组患者给予拉米夫定联合阿德福韦治疗;均连续治疗12个月,分别观察治疗6、12个月HBV-DNA阴转率、HBeAg阴转率和ALT复常率、HBV-DNA数量、血清谷丙转氨酶(ALT)、总胆红素(TBIL)等指标。结果观察组患者治疗后12个月HBV-DNA阴转率、HBeAg阴转率和ALT复常率分别为66.67%、72.31%和79.37%,均高于对照组,两组患者治疗后12个月各项指标均高于治疗后6个月,差异有统计学意义(P<0.05);观察组患者治疗后12个月HBV-DNA数量、ALT和TBIL结果分别为(0.78±0.19)×103 copies/ml、(40.36±5.13)U/L和(37.41±4.46)μmol/L,均低于对照组,两组患者治疗后12个月各项指标均高于治疗后6个月,差异有统计学意义(P<0.05)。结论拉米夫定联合阿德福韦治疗慢性乙型肝炎具有较好的临床效果,HBV病毒量显著降低,肝功能显著改善,值得临床推广应用。
OBJECTIVE To explore the clinical effect of lamivudine combined with adefovir dipivoxil on treatment of chronic hepatitis B and observe the prognosis so as to improve the liver function.METHODS From Jun 2011 to Jun2014,a total of 126 patients with chronic hepatitis B were enrolled in the study and randomly divided into the control group and the observation group,with 63 cases in each.The control group was treated with adefovir dipivoxil,while the observation group was given lamivudine combined with adefovir dipivoxil,and both groups were treated for 12 consecutive months;the negative rates of HBV-DNA,negative rates of HBeAg,rates of ALT restoring to normal,HBV-DNA quantity,serum alanine aminotransferase(ALT),and total bilirubin(TBIL)were respectively observed after the treatment for 6and 12 months.RESULTS After the treatment for 12 months,the negative rate of HBV-DNA,negative rate of HBeAg,and rate of ALT restoring to normal of the observation group were respectively 66.67%,72.31%,and 79.37%,higher than those of the control group,all the indicators of both groups were higher after the treatment for 12 months than after the treatment for 6months and there was significant difference(P<0.05).After the treatment for 12 months,the HBV-DNA quantity of the observation group was(0.78±0.19)×103 copies/ml,lower than that of the control group;the level of ALT of the observation group was(40.36±5.13)U/L,lower than that of the control group;the level of TBIL of the observation group was(37.41±4.46)μmol/L,lower than that of the control group;all the indicators of both groups were higher after the treatment for 12 months than after the treatment for 6 months,with statistical significance(P<0.05).CONCLUSIONLamivudine combined with adefovir dipivoxil can achieve significant clinical effect on treatment of chronic hepatitis B,with the HBV quantity remarkably decreased,the liver function significantly improved,and it is worthy to be promoted.
OBJECTIVE To explore the clinical effect of lamivudine combined with adefovir dipivoxil on treatment of chronic hepatitis B and observe the prognosis so as to improve the liver function.METHODS From Jun 2011 to Jun2014,a total of 126 patients with chronic hepatitis B were enrolled in the study and randomly divided into the control group and the observation group,with 63 cases in each.The control group was treated with adefovir dipivoxil,while the observation group was given lamivudine combined with adefovir dipivoxil,and both groups were treated for 12 consecutive months;the negative rates of HBV-DNA,negative rates of HBeAg,rates of ALT restoring to normal,HBV-DNA quantity,serum alanine aminotransferase(ALT),and total bilirubin(TBIL)were respectively observed after the treatment for 6and 12 months.RESULTS After the treatment for 12 months,the negative rate of HBV-DNA,negative rate of HBeAg,and rate of ALT restoring to normal of the observation group were respectively 66.67%,72.31%,and 79.37%,higher than those of the control group,all the indicators of both groups were higher after the treatment for 12 months than after the treatment for 6months and there was significant difference(P<0.05).After the treatment for 12 months,the HBV-DNA quantity of the observation group was(0.78±0.19)×103 copies/ml,lower than that of the control group;the level of ALT of the observation group was(40.36±5.13)U/L,lower than that of the control group;the level of TBIL of the observation group was(37.41±4.46)μmol/L,lower than that of the control group;all the indicators of both groups were higher after the treatment for 12 months than after the treatment for 6 months,with statistical significance(P<0.05).CONCLUSIONLamivudine combined with adefovir dipivoxil can achieve significant clinical effect on treatment of chronic hepatitis B,with the HBV quantity remarkably decreased,the liver function significantly improved,and it is worthy to be promoted.
引文
[1]魏兆勇,张分明,许德军,等.拉米夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化临床观察[J].中华医院感染学杂志,2014,24(2):361-363.
[2]Wiegand J,Wedemeyer H,Franke A,et al.Treatment of severe,nonfulminant acute hepatitis B with lamivudine vs placebo:aprospective randomized double-blinded multicentre trial[J].J Vir Hepa,2014,21(10):744-750.
[3]Montasser MF,Abdelkader NA,Ismail SA,et al.Pretreatment and on-treatment indicators of virologic breakthrough of lamivudine therapy in chronic hepatitis B patients:an Egyptian study[J].Acta Virologica,2014,58(3):231-237.
[4]王婧.拉米夫定联合阿德福韦酯治疗慢性乙型肝炎肝硬化的疗效观察[J].临床和实验医学杂志,2014,13(6):498-450.
[5]黄美金,覃后继,何延专.拉米夫定耐药慢性乙型肝炎患者改用或加用阿德福韦酯治疗48周疗效比较[J].临床肝胆病杂志,2014,30(7):636-638.
[6]贾德兴,冯静,李萍.拉米夫定和阿德福韦酯抗乙型肝炎病毒耐药位点检测及临床意义[J].实用肝脏病杂志,2014,17(5):497-500.
[2]Wiegand J,Wedemeyer H,Franke A,et al.Treatment of severe,nonfulminant acute hepatitis B with lamivudine vs placebo:aprospective randomized double-blinded multicentre trial[J].J Vir Hepa,2014,21(10):744-750.
[3]Montasser MF,Abdelkader NA,Ismail SA,et al.Pretreatment and on-treatment indicators of virologic breakthrough of lamivudine therapy in chronic hepatitis B patients:an Egyptian study[J].Acta Virologica,2014,58(3):231-237.
[4]王婧.拉米夫定联合阿德福韦酯治疗慢性乙型肝炎肝硬化的疗效观察[J].临床和实验医学杂志,2014,13(6):498-450.
[5]黄美金,覃后继,何延专.拉米夫定耐药慢性乙型肝炎患者改用或加用阿德福韦酯治疗48周疗效比较[J].临床肝胆病杂志,2014,30(7):636-638.
[6]贾德兴,冯静,李萍.拉米夫定和阿德福韦酯抗乙型肝炎病毒耐药位点检测及临床意义[J].实用肝脏病杂志,2014,17(5):497-500.