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目的:研究阿德福韦酯与恩替卡韦单用和拉米夫定联合阿德福韦酯对拉米夫定耐药慢性乙型肝炎患者的临床疗效。方法:采用对照研究的方式对门诊及住院部收集的108例拉米夫定耐药慢性乙型肝炎患者进行分析,以治疗方式的不同为依据将其定义为A组(32例,单用阿德福韦酯治疗)、B组(37例,单用恩替卡韦治疗)、C组(39例,拉米夫定联合阿德福韦酯治疗);分析比较其疗效。结果:治疗1年后三组患者在AST、ALT、TBi L、ALB等指标改善以及病毒总应答率、ALT复常率、和乙肝病毒DNA转阴率的比较上,P均<0.05,差异具有显著统计学意义。结论:1拉米夫定耐药慢性乙型肝炎患者单用药物治疗方案中恩替卡韦优于阿德福韦酯;2拉米夫定联合阿德福韦酯用药疗效优于两种单用药物;有效抑制乙肝病毒DNA水平,恢复患者肝功能,降低患者对单一药物的耐药性,具有较高的临床使用价值。
Objective: To study the clinical efficacy of adefovir dipivoxil and entecavir monotherapy and lamivudine combined with adefovir dipivoxil on lamivudine-resistant chronic hepatitis B patients. Methods: A total of 108 patients with lamivudine-resistant chronic hepatitis B collected from outpatient department and inpatient department were analyzed by means of a controlled study, which was defined as group A (32 patients) (37 cases treated with entecavir alone) and group C (39 cases treated with lamivudine plus adefovir dipivoxil). The curative effect was analyzed and compared. Results: After one year of treatment, the three groups of patients had significantly lower P <0.05 than those with improvement of AST, ALT, TBiL and ALB, total virus response rate, ALT normalization rate and hepatitis B virus DNA negative conversion rate Significant statistical significance. Conclusion: 1 lamivudine-resistant chronic hepatitis B patients with single drug therapy entecavir better than adefovir dipivoxil; lamivudine combined with adefovir dipivoxil drug efficacy is superior to two single drug; Effective inhibition of hepatitis B virus DNA levels, recovery of liver function, reduce drug resistance of patients with a single drug, with high clinical value.