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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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