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目的探讨替比夫定联合阿德福韦酯对HBeAg阳性慢性乙型肝炎患者的疗效。方法将76例慢性乙型肝炎患者分为干扰素组和替比夫定组,干扰素组应用聚乙二醇干扰素α-2a联合阿德福韦酯,替比夫定组给予替比夫定联合阿德福韦酯,治疗48周,观察血清谷氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)的含量和正常化率及血清HBsAg、HBeAg和乙肝病毒(HBV)DNA的含量及HBeAg阴转率和血清转换率及HBV DNA低于检测下限值率变化。结果 2组治疗后24周和48周ALT和AST的含量及血清HBsAg、HBeAg和HBV DNA的含量均明显降低(P<0.01),而替比夫定组治疗后降低量更显著;ALT和AST正常化率,HBeAg阴转率和血清转换率及HBV DNA低于检测下限值率显著增加(P<0.01),而替比夫定组治疗后的增加量更显著。结论替比夫定联合阿德福韦酯的治疗效果比干扰素联合阿德福韦酯的治疗更加显著。
Objective To investigate the effect of telbivudine combined with adefovir dipivoxil on HBeAg-positive chronic hepatitis B patients. Methods 76 cases of chronic hepatitis B patients were divided into interferon group and telbivudine group, interferon group with pegylated interferon α-2a combined with adefovir dipivoxil group were given telbivudine Adefovir dipivoxil was given for 48 weeks. The levels of serum glutamate aminotransferase (ALT) and aspartate aminotransferase (AST) and the normalization rate of serum HBsAg, HBeAg and hepatitis B virus (HBV) ) DNA content and HBeAg negative rate and seroconversion rate and HBV DNA below the detection limit rate changes. Results The levels of ALT and AST and the levels of serum HBsAg, HBeAg and HBV DNA were significantly decreased in both groups at 24 weeks and 48 weeks after treatment (P <0.01), while those in telbivudine group were more pronounced after treatment. ALT and AST The normalization rate, the negative rate of HBeAg, the seroconversion rate and the HBV DNA level below the limit of detection were significantly increased (P <0.01), while those in the telbivudine group were more significant. Conclusion The effect of telbivudine combined with adefovir dipivoxil is more significant than that of interferon combined with adefovir dipivoxil.