【摘要】 目的观察阿德福韦酯治疗HBeAg阳性慢性乙型肝炎和拉米夫定治疗无效的慢性乙型肝炎患者,单药连续144周治疗,停药后监测96周疗效和药物安全性。方法初始治疗69例,拉米夫定治疗无效再治疗32例共101例,采用单药阿德福韦酯(ADV)10mg,每日1次口服,连续治疗144周,疗程结束继续监测到240周。结果阿德福韦酯初治组和复治组经144周连续治疗和停药后监测至240周血清ALT累积复常率分别为91.3%和90.6%,血清HBV DNA转阴率分别为88.4%和84.3%,HBeAg转阴率分别为34.7%和28.1%,HBeAg/HB-eAb血清转换率分别为55.0%和53.1%,HBsAg/HBsAb血清学转换均在停药后不同时间段发生,初治组为7.2%,复治组为6.3%。经144周连续治疗和停药后随访期间血、尿常规和肾功能,均无与治疗相关的异常发现。结论阿德福韦酯单药10mg每日1次口服治疗HBeAg阳性慢性乙型肝炎患者,有显著抑制HBV DNA复制,对拉米夫定治疗无效患者,可获得同样疗效,长期服药无明显耐药性,安全性好。更多还原

【Abstract】 Objective This study assessed the safety and efficacy of adefovir dipivoxil(ADV)in treatment of patients with chronic hepatitis B and lamivudine-resistant hepatitis B virus(HBV).Methods One hundred and one hepatitis B e-antigen (HBeAg)-positive na ve patients (69 cases)and lamivudine-resistant HBV patients(32 cases)were treated with adefovir dipivoxil 10mg daily.The efficacy was evaluated until at 144th month(the administrated end point)and then continuously at 240th month.Results At the 144th month,the rates of ALT normalization were 91.3% and 90.6% in na ve group and lamivudine-resistant group,respectively;the negative rates of HBV-DNA were 88.4% and 84.3%,respectively;the negative rates HBeAg were 34.7% and 28.1%,respectively;the seroconversion rates of HBeAg/HBeAb were 55.5% and 53.1%,respectively,and the seroconversion rates of HBsAg/HBsAb were 7.2% and 6.3%,respectively.There was no significant difference between the two groups (P>0.05).The blood routine,urine routine and renal functions whether in the administered period or during the follow-up had no abnormal findings related to ADV.Conclusions Adefovir dipivoxil could effectively inhibit HBV replication,normalize ALT and enhance transformation from HBeAg to HBeAb for cases with naive patients and lamivudine-resistant patients.It is safe and has a good tolerance.更多还原