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目的观察慢性乙型肝炎(乙肝)、乙肝肝硬化代偿期和失代偿期患者接受阿德福韦酯(ADV)抗病毒治疗2年的疗效。方法对初治的慢性乙肝32例(慢性乙肝组)、乙肝肝硬化代偿期10例(肝硬化代偿期组)和失代偿期14例(肝硬化失代偿期组)应用ADV治疗2年,治疗前和治疗后每3个月检测ALT等生化指标及HBVDNA等病毒学指标。结果 3组患者在治疗前各项指标基线水平无显著差异,具有可比性。ADV治疗1年和2年时,3组ALT的复常率和HBeAg血清学转换率之间差异无统计学意义(P>0.05)。治疗2年时慢性乙肝组HBVDNA水平下降的中位数为5.9log10U/ml,肝硬化代偿期组为6.2log10U/ml,肝硬化失代偿期组为2.9log10U/ml。肝硬化失代偿期组在治疗6个月后的病毒学应答比慢性乙肝组和肝硬化代偿期组差。结论接受ADV治疗2年的慢性乙肝、肝硬化代偿期和失代偿期患者中,肝硬化失代偿期患者病毒学应答差。
Objective To observe the efficacy of adefovir dipivoxil (ADV) antiviral therapy in patients with chronic hepatitis B (hepatitis B) and decompensated and decompensated hepatitis B patients for 2 years. Methods 32 patients with chronic hepatitis B (chronic hepatitis B group), 10 patients with decompensated liver cirrhosis (decompensated liver cirrhosis group) and 14 patients with decompensated liver cirrhosis (decompensated liver cirrhosis group) were treated with ADV 2 years, before treatment and every 3 months after treatment to detect biochemical indicators such as ALT and HBVDNA and other virological indicators. Results There was no significant difference between baseline and baseline before treatment in all three groups, which was comparable. There was no significant difference in the normalization rate of ALT and HBeAg seroconversion between the three groups at 1 year and 2 years after ADV treatment (P> 0.05). At 2 years, the median decrease in HBVDNA levels in patients with chronic hepatitis B was 5.9log10U / ml, 6.2log10U / ml in patients with decompensated liver cirrhosis, and 2.9log10U / ml in patients with decompensated cirrhosis. The virologic response to decompensated liver cirrhosis after 6 months of treatment was worse than that of chronic hepatitis B and decompensated liver cirrhosis. Conclusions Among the patients with chronic hepatitis B, decompensated and decompensated liver cirrhosis who received ADV for 2 years, the virological response was poor in patients with decompensated cirrhosis.