阿德福韦酯治疗慢性乙型肝炎早期疗效分层评价
摘 要 目的：评价阿德福韦酯（ADV）对不同类型慢性乙型肝炎（CHB）患者的疗效。方法：将62例慢性乙型肝炎患者分别根据血清HBeAg水平、LMV治疗经历、疾病进展程度、谷ALT水平不同，每组均应用阿德福韦酯10mg，1次/日治疗。观察指标：基线及治疗12、24、48周血清HBV DNA水平、HBV血清标志物及肝功能变化。结果：核苷类似物初治组与拉米夫定耐药组HBV DNA应答率差异有统计学意义，12、24、48周分别为54.83%、26.67%（P＜0.05），61.29%、33.33%（P＜0.01），77.42%、46.67%（P＜0.01）。而其他分组间的病毒应答率差异无统计学意义。结论：阿德福韦酯对不同类型慢性乙型肝炎（CHB）患者的疗效确切，抗病毒效果好，但是核苷初治者明显优于拉米夫定耐药者。而其他组间对比ADV抗病毒活性相近。
关键词 阿德福韦酯 慢性乙型肝炎 HBV DNA 抗病毒治疗
AbstractObjective:To evalution effect of adefovir dipivoxil（ADV） on different typys of chronic Hepatitis B （CHB） Methods:62 Cases of CHB were selected randomly .According to HBeAg condition ,treatment history with lamivudine（LVD）,progress of disease,levels of ALT,They were all treated daily dose of ADV 10mg,Evaluation indexes serum HBV DNA,HBV serological markers,and the liver function tests at baselin,week-12,week-24,week-48,with ADV therapy,Results:undetectable serum HBV DNA at week-12,week-24 and in nucleoside-analogue native group were 54.837%,61.29%,77.42% respectively ,which were superior to that in LVD-refractory group （26.67%,33.33%,46.67%）,There was no significant difference of virological response to the other groupsConclusion:ADV can suppress HBV DNA rapidly for chronic hepatitis B patients The effect of nucleoside-analogue na？ve group with ADV therapy was superior to that of LVD-refractory group The effect of ADV therapy has no significant difference between the other groups.
Key wordsAdefovir Dipivoxil;Chronic hepatitis B;HBV DNA;Anti-viral therapy
乙型肝炎病毒（hepatitis B virus,HBV）感染是世界上最...
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