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目的评价替比夫定联合阿德福韦酯治疗慢性乙肝的有效性。方法将84例患者随机分为替比夫定组、阿德福韦酯组、替比夫定联合阿德福韦酯组。观察3组HBeAg/HBeAb血清转换率、HBV DNA转阴率、ALT的变化情况。结果治疗后12周和治疗后24周三组血清HBV DNA、ALT均较治疗前明显降低,差异有显著性意义(P<0.05)。治疗后12周联合治疗组与阿德福韦酯组血清HBV DNA比较,差异有显著性意义(P<0.05)。治疗后12周联合治疗组与替比夫定组、阿德福韦酯组ALT比较,差异有显著性意义(P<0.05)。治疗后24周联合治疗组与阿德福韦酯组HBeAg/HBeAb血清转换率、HBV DNA转阴率比较,差异有显著性意义(P<0.05)。结论替比夫定与阿德福韦酯联合应用具有更强的抗病毒活性和快速抑制HBV-DNA的能力。两药合用既可以克服病毒对替比夫定的耐药性,又可以提高两药的抗病毒能力。
Objective To evaluate the efficacy of telbivudine in combination with adefovir dipivoxil in the treatment of chronic hepatitis B. Methods Eighty-four patients were randomly divided into telbivudine group, adefovir dipivoxil group and telbivudine plus adefovir dipivoxil group. The changes of serum HBeAg / HBeAb seroconversion rate, HBV DNA negative rate and ALT were observed in the three groups. Results The levels of serum HBV DNA and ALT in the three groups after 12 weeks and 24 weeks after treatment were significantly lower than those before treatment (P <0.05). The difference of serum HBV DNA between the combination therapy group and the adefovir dipivoxil group after 12 weeks of treatment was significant (P <0.05). Twelve weeks after treatment, there was significant difference in the ALT between the combination therapy group and telbivudine group and adefovir dipivoxil group (P <0.05). After 24 weeks of treatment, HBeAg / HBeAb seroconversion rate and HBV DNA negative rate in combination therapy group and adefovir dipivoxil group were significantly different (P <0.05). Conclusion The combination of telbivudine and adefovir dipivoxil has stronger anti-viral activity and rapid inhibition of HBV-DNA. The combination of the two drugs can overcome the resistance of the virus to telbivudine and improve the anti-virus ability of the two drugs.