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The use of entecavir in the treatment of lamivudine-resistant chronic hepatitis B
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摘要: 目的比较恩替卡韦（ETV）和阿德福韦酯（ADV）治疗拉米夫定（LAM）耐药慢性乙肝患者的疗效。方法LAM耐药发生生化学突破的患者根据肝功受损严重程度分别给予ETV和ADV+LAM治疗,观察治疗4周后临床症状、生化学及HBVDNA的变化。结果LAM耐药后肝功能轻到中度受损的患者,两种治疗方案均可明显改善病情,与治疗前比较差异有统计学意义（P<0.05）;两组比较无显著性差异（P>0.05）。对于耐药后肝功严重受损的患者,给予ETV1.0mg/d治疗,4周后,除3例患者死亡外,其余患者病情均得到较好控制,与治疗前比较差异有统计学意义（P<0.05）。结论LAM耐药后肝功能轻到中度受损的患者,两种治疗方案,均有较好的疗效。对于耐药后肝功严重受损的患者,最好给予ETV治疗以尽快控制病毒。Abstract: Objective To evaluate the efficacy of entecavir (ETV) and adefovir dipivoxil (ADV) in the treatment of lamivudine-resistant chronic hepatitis B (CHB) .Methods According to the serum aminotransferase levels, ETV and ADV plus LAM were given to the LAM-resistant CHB patients.After 4 weeks treatment, the symptoms, aminotransferase and HBVDNA levels were evaluated.Results 38 patients with mild and moderate liver damage had shown a significant improvement by the two treatments (p<0.05) .There was no significant difference between the two kinds of treatment.From the total of 17 patients with severe liver damage, 14 were shown a significant improvement by ETV (p<0.05) .Conclusion ETV and ADV plus LAM show a better result in the treatment of LAM-resistant CHB patients with mild and moderate liver damage and ETV is more effective for treating patients with severe liver damage.
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Key words:
- lamivudine-resistant /
- entecavir /
- adefovir
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[1] 中华医学会.病毒性肝炎防治方案[J].中华传染病杂志, 2000, 19∶56-62. [2]中华医学会.肝衰竭诊疗指南[J].国际流行病学传染病学杂志, 2006, 33 (4) ∶207-221. [3]Iloeje U, Yang HI, Su J, et al.Predicting Cirrhosis Risk Based on the Level of CirculatingHepatitis B Viral Load[J].Gastroenterology, 2006, 130 (3) ∶678-686. [4]Chen CJ, Yang HI, MD JS, et al.Risk of Hepatocellular Carcinoma Across a Biological Gradient of Serum Hepatitis B Virus DNA Level[J].Hepatocellular Carcinoma Risk, 2006, 295 (1) ∶65-73. [5]Keung NWY, Lai CL, Chang TT, et al.Extended lamivudine reat-ment in patients with chronic hepatitis B enhances hepatitis Be anti-gen seroconversion rates:results after5years of therapy[J].Hepatol-ogy, 2001, 33 (6) ∶1527-1532. [6]Sherman M, Yurdaydin C, Simsek H, et al.Entecavir terapy for Lamivudine-Refractory Chronic Hepatitis B:Improved Virologic, Biochemical, and Serology Outcomes Through96Weeks[J].Hepa-tology, 2008, 48 (1) , 1-10. [7]Rapti I, Dimou E, Mitsoula P, et al.Adding-on versus switching-to adefovir therapy in lamivudine-resistant HBeAg-negative chronic hepatitis B[J].Hepatology, 2007, 45 (2) ∶407-311. [8] 邱源旺, 蒋祥虎, 黄利华, 等.肝硬化患者YMDD变异后治疗的临床研究[J].国家流行病学传染病学杂志, 2008, 35 (5) ∶301-303. [9]姚光弼, 任红, 王宝恩, 等.恩替卡韦治疗拉米夫定失效的慢性乙型肝炎患者多中心随机双盲对照临床研究[J].肝脏, 2005, 10 (1) ∶2-4. -
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