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摘要: 目的探讨阿德福韦酯治疗拉米夫定失效的慢性乙型肝炎的疗效及不良反应。方法选择拉米夫定治疗失效的CHB患者234例,随机分为阿德福韦酯组186例和拉米夫定组48例。完成为期12月的治疗后,检测肝生化功能指标ALT、AST、TBil及血清HBVDNA、HBV-M水平的变化。结果在治疗6个月时,阿德福韦酯组患者血清ALT复常率、HBVDNA阴转率分别为58.3和25.3,均显著高于拉米夫定组的20.0和10.4;在治疗12个月时,阿德福韦酯组患者血清ALT复常率、HBVDNA阴转率分别为76.5和50.0,亦显著高于拉米夫定组的16.7和12.5;而阿德福韦酯组治疗后HBeAg阴转率及HBeAg血清转换率与拉米夫定组比较差异无显著性;所有病例均未见严重不良反应。结论阿德福韦酯治疗拉米夫定失效的慢性乙型肝炎的疗效肯定,安全性及耐受性良好。
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