替比夫定单用及联用阿德福韦酯抗病毒对比研究

发布时间：2018-01-20 02:54

本文关键词： 替比夫定阿德福韦酯 HBeAg阳性慢性乙型肝炎抗病毒　出处：《北方药学》2016年11期 　论文类型：期刊论文

【摘要】：目的:对替比夫定(LDT)初始单用及联用阿德福韦酯(ADV)治疗HBeAg阳性慢性乙型肝炎(CHB)抗病毒的长期效果、安全性进行回顾性研究。方法:选取本院收录的98例HBeAg阳性慢性乙型肝炎患者,随机分为单一组(LDT,50例)和联合组(LDT加ADV48例)。初始单一组给予LDT 600mg/次/d,初始联合组在上述剂量基础上联合ADV 10mg/次/d。口服给药96周一个疗程后观察两组疗效、耐药发生率、不良反应情况,检测24周、48周和96周不同时间点的HBV血清学标志物、HBV DNA定量、肝功能、肾功能、肌酶等。结果:与单一组相比,联合组有效率和耐药发生率具有显著差异(P0.01或P0.05)。两组都未出现呼吸道感染、血肌酸激酶升高等不良反应。此外,随治疗时间延长,两组HBeAg阴转率逐渐增加,24周和48周两组差异无统计学意义(P0.05),当96周时有显著差异(P0.01)。而HBV-DNA和ALT水平随着时间延长降低,24周、48周和96周两组相比差异具有统计学意义(P0.01)。结论:替比夫定联合阿德福韦酯抗病毒可延缓或避免耐药发生,同时发挥二者的特点和优势,提高临床治疗效果。
[Abstract]:Objective: to evaluate the long-term antiviral effect of tibivudine (LDT) in the treatment of HBeAg positive chronic hepatitis B (CHB) with adefovir alone or in combination with adefovir. Methods: 98 patients with HBeAg positive chronic hepatitis B were randomly divided into a single group. The first group was given LDT 600mg / rd at the beginning of the single group (n = 50) and the combined group (n = 50) and the combined group (n = 50) were given LDT 600 mg / d. After 96 weeks of oral administration, the two groups were observed for the efficacy, incidence of drug resistance, adverse reactions and 24 weeks. The serum markers of HBV at different time points at 48 and 96 weeks were measured. Results: compared with the single group, the levels of HBV DNA, liver function, renal function, muscle enzyme and so on were measured. There were significant differences in the effective rate and the incidence of drug resistance between the two groups (P 0.01 or P 0.05). There were no adverse reactions such as respiratory tract infection and elevated serum creatine kinase in both groups. In addition, the treatment time was prolonged. There was no significant difference in HBeAg negative conversion rate between the two groups at 24 and 48 weeks (P 0.05). At 96 weeks, there was a significant difference (P 0.01). However, the levels of HBV-DNA and ALT decreased at 24 weeks with the prolongation of time. Conclusion: the antiviral effect of tibivudine combined with adefovir ester can delay or avoid the occurrence of drug resistance and give full play to the characteristics and advantages of the two groups. To improve the effect of clinical treatment.
【作者单位】：广东省梅州市人民医院感染科;广东省梅州市人民医院检验科;
【分类号】：R512.62
【正文快照】： 乙型肝炎病毒(hepatitis B virus,HBV)感染是危害我国乃至世界人类健康的重大疾病之一[1]。至今国内外公认用于慢性乙型肝炎(CHB)抗病毒治疗的药物有干扰素和核苷(酸)类似物,后者为当前主流治疗手段包括替比夫定(Ld T)、阿德福韦酯(ADV)、恩替卡韦(ETV)等[2]。LDT在2007年批准

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