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时间:2020-05-08
《恩替卡韦联合阿德福韦酯对拉米夫定耐药乙肝肝硬化的疗效-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、胃肠病学月干病学杂志2013年11月第22卷第11期ChinJGastroenterolHepatol,Nov2013,Vo1.22,No.11·1141·doi:10.3969/j.issn.1006-5709.2013.11.027恩替卡韦联合阿德福韦酯对拉米夫定耐药乙肝肝硬化的疗效李超无锡市第五人民医院肝病科,江苏无锡214005【摘要】目的研究恩替卡韦(ENT)联合阿德福韦酯(ADV)治疗对拉米夫定耐药乙型肝炎肝硬化的临床疗效。方法选取98例对拉米夫定耐药乙型肝炎肝硬化患者分为代偿期和失代偿期,两
2、组患者均给予恩替卡韦(0.5mg/d,qd)和阿德福韦酯(10mg,qd)治疗。两组患者分别在治疗前、治疗24周和48周收集患者的血清样本检测HBVDNA阴转率、ALT复常率、评估Child—Pugh评分和与药物相关的不良反应。结果治疗24周、48周时两组患者的HBVDNA阴转率、HBeAg阴转率、ALT复常率与治疗前相比均得到显著改善,治疗24周和48周时,两组HBeAg阴转率、HBVDNA阴转率、ALT复常率比较,差异有统计学意义(P<0.05)。Child—Pugh评分与治疗前相比得到改善,但差异无
3、统计学意义(P>0.05),治疗24周和48周时,两组Child—Pugh评分比较差异有统计学意义(P<0.05)。未见不良反应和病毒学突破。结论恩替卡韦联合阿德福韦酯治疗乙型肝炎肝硬化可以有效抑制乙肝病毒复制,延缓疾病进展,安全性良好。【关键词】恩替卡韦;阿德福韦酯;乙型肝炎肝硬化;耐药中图分类号:R512.62文献标识码:A文章编号:1006—5709(2013)11—1141—03收稿日期:2013—0408Effectofentecavircombinedwithadefovirdipivoxil
4、intreatmentoflamivudine-resistanthepatitisBcirrhosispatientsLIChaoDepartmentofHepatopathy,WuxiNO.5People’SHospital,Wuxi214005,China【Abstract】0bjectiveToexploretheclinicaleffectofentecavir(ENT)combinedwithadefovirdipivoxil(ADV)intreatmentofhepatitisBcirrho
5、sis.MethodsNinety—eightlamivudine—resistanthepatitisBcirrhosispatientsweretreatedwithdailydoseofENT0.5mgandADV10mgfor48weeksatleast.TheratesofHBeAgloss,HBVDNAclearance,ALTnormalizationandChild—Pughscoreatthe24thweek,48thweekobservationpointsandtheantivira
6、ldrugsassociat—edadversereactionwereanalyzed.ResultsAtthe24thand48thweeks,theratesofHBeAglOSS.HBVDNAclear—ance,ALTnormalizationofthepatientsweresignificantlyimprovedcomparedwiththosebeforetreatment(P<0.01),thereweresignificantdifferencesintheratesofHBeAgl
7、oss,HBVDNAclearance,ALTnormalizationbetweentwogroupsafter24weeksand48weekstreatment;theChild—PughscoresofthehepatitisBcirrhosispatientswerenotsignif-icantlyimprovedcomparedwiththosebeforetreatment(P>0.05),therewassignificantdifferenceinChild—Pughscorebetw
8、eentwogroupsafter24weeksand48weekstreatment,adversedrugreactionandvirologicalbreakthroughwerenofound.ConclusionENTcombinedwithADVintreatmentofhepatitisBcirrhosispatientscouldinhibitethevirusrepli—cationanddelaydisea
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