【摘要】 目的 觀察阿德福韋酯聯合拉米夫定治療阿德福韋酯治療48周后應答不佳，HBeAg陽性慢性乙型肝炎的療效和安全性。 方法 選擇2006年1月-2010年12月間阿德福韋酯治療48周后乙型肝炎病毒 DNA gt;104 copies/mL的26例慢性乙型肝炎患者，給與拉米夫定（100 mg，1次/d）聯合治療。觀察治療12周，24周時的應答情況。 結果 所有納入26例患者在聯合拉米夫定優化治療24周后，無論是病毒學應答還是血清學應答都獲得顯著的改善，無一例患者觀察到有耐藥以及藥物不良反應發生。 結論 聯合拉米夫定是對阿德福韋酯應答不佳慢性乙型肝炎患者安全有效的干預策略之一。
【Abstract】 Objective To observe the effect and safety of adefovir dipivoxil (ADV) combined with lamnivudine (LAM) in treating HBeAg-positive chronic hepatitis B (CHB) patients with poor response to ADV monotherapy for 48 weeks. Methods Twenty-six HBeAg-positive CHB patients received initial treatment of ADV from January 2006 to December 2010, and their serum HBV-DNA still maintained over or equal to 1.0×104 copies/mL after 48 weeks. These patients received the optimized treatment of ADV (10 mg, one time per day) combined with LAM (100 mg, one time per day). Patients′ responses to the treatment at the 12th and 24th week were observed. Results Compared with baseline, ADV plus LAM had an improved response rate of virological response, biochemical response and HBeAg/HBeAb seroconversion. No LAM-resistant or ADV-resistant mutations were detected. In all the 26 patients, no adverse reactions were observed. Conclusion Optimized therapy combining LAM and ADV can be a good choice for patients with hepatitis B who have a poor response to ADV monotherapy.
引用本文： 白浪,楊文斌,劉麗,劉聰,唐紅. 阿德福韋酯聯合拉米夫定治療阿德福韋酯應答不佳的慢性乙型肝炎的臨床觀察. 華西醫學, 2011, 26(9): 1281-1283. doi: 復制