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华西医学  2011 

阿德福韦酯联合拉米夫定治疗阿德福韦酯应答不佳的慢性乙型肝炎的临床观察

, PP. 1281-1283

Keywords: 慢性乙型肝炎,阿德福韦酯,应答不佳,联合治疗

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Abstract:

【】 目的 观察阿德福韦酯联合拉米夫定治疗阿德福韦酯治疗48周后应答不佳,HBeAg阳性慢性乙型肝炎的疗效和安全性。 方法 选择2006年1月-2010年12月间阿德福韦酯治疗48周后乙型肝炎病毒DNA>104copies/mL的26例慢性乙型肝炎患者,给与拉米夫定(100mg,1次/d)联合治疗。观察治疗12周,24周时的应答情况。 结果 所有纳入26例患者在联合拉米夫定优化治疗24周后,无论是病毒学应答还是血清学应答都获得显著的改善,无一例患者观察到有耐药以及药物不良反应发生。 结论 联合拉米夫定是对阿德福韦酯应答不佳慢性乙型肝炎患者安全有效的干预策略之一。【Abstract】 Objective Toobservetheeffectandsafetyofadefovirdipivoxil(ADV)combinedwithlamnivudine(LAM)intreatingHBeAg-positivechronichepatitisB(CHB)patientswithpoorresponsetoADVmonotherapyfor48weeks. Methods Twenty-sixHBeAg-positiveCHBpatientsreceivedinitialtreatmentofADVfromJanuary2006toDecember2010,andtheirserumHBV-DNAstillmaintainedoverorequalto1.0×104copies/mLafter48weeks.ThesepatientsreceivedtheoptimizedtreatmentofADV(10mg,onetimeperday)combinedwithLAM(100mg,onetimeperday).Patients′responsestothetreatmentatthe12thand24thweekwereobserved. Results Comparedwithbaseline,ADVplusLAMhadanimprovedresponserateofvirologicalresponse,biochemicalresponseandHBeAg/HBeAbseroconversion.NoLAM-resistantorADV-resistantmutationsweredetected.Inallthe26patients,noadversereactionswereobserved. Conclusion OptimizedtherapycombiningLAMandADVcanbeagoodchoiceforpatientswithhepatitisBwhohaveapoorresponsetoADVmonotherapy.

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