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目的探讨慢性乙型肝炎患者使用干扰素抗病毒治疗失败后,序贯阿德福韦酯再治疗的疗效。方法选择同期慢性乙型肝炎患者59例,分为序贯组26例和初治组33例,采用荧光定量聚合酶链反应(FQ-PCR)检测HBVDNA,采用微粒子化学发光法检测HBeAg定量,对2组的ALT复常率、HBVDNA转阴率、HBeAg定量及HBeAg血清学转换率分别于3、6、9、12个月时进行比较。结果 2组患者血清HBeAg、HBVDNA转阴率差异无统计学意义(P均>0.05);HBeAg定量检测序贯组3、6、9、12个月时均明显低于初治组(P均<0.05)。结论慢性乙型肝炎患者使用干扰素抗病毒治疗失败后,序贯阿德福韦酯治疗比初始即选用阿德福韦酯抗病毒治疗可明显降低HBeAg定量值,也有助于增加HBeAg与HBVDNA转阴率。
Objective To investigate the efficacy of sequential adefovir dipivoxil treatment after failure of interferon antiviral therapy in patients with chronic hepatitis B. Methods Fifty-nine patients with chronic hepatitis B were enrolled in this study. They were divided into sequential group (n = 26) and initial treatment group (n = 33). HBVDNA was detected by FQ-PCR and HBeAg quantitation by microparticle chemiluminescence The ALT normalization rate, HBVDNA negative rate, HBeAg quantitative rate and HBeAg seroconversion rate in 2 groups were compared at 3, 6, 9 and 12 months respectively. Results There was no significant difference in serum HBeAg and HBVDNA negative rates between the two groups (all P> 0.05). HBeAg quantification was significantly lower at 3, 6, 9 and 12 months in the sequential group than in the untreated group (P < 0.05). Conclusions After the failure of interferon antiviral therapy in patients with chronic hepatitis B, sequential adefovir dipivoxil treatment can lower the quantitative value of HBeAg than the initial choice of adefovir dipivoxil and also increase the ratio of HBeAg and HBVDNA Yin rate.