替比夫定治療HBeAg陽性慢性乙型肝炎的臨床觀察-論文.pdf

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1、替比夫定治療HBeAg陽性慢性乙型肝炎的臨床觀察宗燕H，樓文文(1．義烏市中心醫(yī)院感染科，浙江義烏322000；2．義烏市第三人民醫(yī)院外科，浙江義烏322000)中圖分類號R512．62文獻(xiàn)標(biāo)志碼A文章編號1001—0408(2014)36-3423—03DOI10．6039／j．issn．1001—0408．2014．36．18摘要目的：觀察替比夫定治療乙肝病毒e抗原(HBeAg)陽性慢性乙型肝炎的臨床療效和安全性。方法：82例HBeAg陽性慢性乙型肝炎患者按隨機(jī)數(shù)字表法分為觀察組(42例)和對照組(40例)。兩組患者均給

2、予護(hù)肝治療、免疫調(diào)節(jié)、休息等常規(guī)治療。在此基礎(chǔ)上，對照組患者給予阿德福韋酯片10mg，口服，qd；觀察組患者給予替比夫定600mg，口服，qd。兩組患者療程均為l2個月。觀察兩組患者的臨床療效，治療前后乙型肝炎病毒DNA(HBv．DNA)水平和HBV-DNA陰轉(zhuǎn)率，HBeAg血清陰轉(zhuǎn)率和轉(zhuǎn)換率，治療前后丙氨酸氨基轉(zhuǎn)移酶(ALT)水平和ALT復(fù)常率及不良反應(yīng)發(fā)生情況。結(jié)果：治療后觀察組患者總有效率、HBV-DNA陰轉(zhuǎn)率、ALT復(fù)常率顯著高于對照組，兩組比較差異有統(tǒng)計學(xué)意義(P<0．05)；治療3、6、12個月后兩組患者HBV-

3、DNA、ALT均顯著低于同組治療前，且觀察組低于對照組，差異有統(tǒng)計學(xué)意義(P0．05)。結(jié)論：替比夫定治療HBeAg陽性慢性乙型肝炎，療效與安全性較好。關(guān)鍵詞慢性乙型肝炎；HBeAg陽性；替比夫定；療效；安全性ClinicalObservationofTelbivudineintheTreatmentofHBeAg-positiveChronicHepatitisBZONGYan，LOUWen—wen。(1．Dept

4、．ofInfection，YiwuCentralhospital，ZhejiangYiwu322000，China；2．Sur-gicalDepartment，YiwuThirdPeople’sHospital，ZhejiangYiwu322000，China)ABSTRACTOBJECTIVE：Toobserveclinica1emcacyandsafetyoftelbivudineinthetreatmentofHBeAg-positivechronichepa-tifsB．METHODS：82casesofHBeAg．

5、positivechronichepatitisBwererandomlydividedintoobservationgroup(42cases)andcontrolgroup(40cases)．Bothgroupsweregivenconventionaltherapyasliverprotectiontherapy，immuneregulation，rest，etc．ControlgroupwasadditionallygivenAdefovirdipivoxiltablet10mgorallyonceaday；obse

6、rvationgroupwasadditionallygiventelbivudine600mgorallyonceaday．Tlreatmentcourseof2groupslastedfor12months．Clinicalefficacyof2groupswasob-served．ThelevelandnegativerateofHBV-DNA．negativerateandconversionratesofserumHBeAg，thelevelandnormalizationrateOfALTandadversedr

7、ugreactionwereobservedbeforeandaftertreatment．RESULTS：T0talefectiverate，negativerateofHBV．DNAandnonnalizationrateofA【inobservationweresignificantlyhigherthanincontrolgroup：therewasstatisticalsignifi．cance(尸<0．05)，ThelevelsofHBv_DNAandAIin2groupsafter3，6and12monthso

8、ftreatmentweresignificantlylowerthanbefore．a(chǎn)ndthoseofobservationgroupwerelowerthanthoseofcontrolgroup：therewasstatisticalsignificance(P