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目的探索阿德福韦酯治疗慢性乙型肝炎疗效欠佳者改用替比夫定的疗效。方法将32例阿德福韦酯治疗慢性乙型肝炎疗效欠佳者在继续应用常规保肝药物的基础上改用替比夫定600mg口服,1次/d。在第3、6、12月各检测HBVM、HBV-DNA及肝功能,观察治疗前后的疗效。结果阿德福韦酯治疗慢性乙型肝炎疗效欠佳者换用替比夫定后3、6、12月时的HBV-DNA阴转率、HBeAg阴转率、HBeAb阴转率、ALT复常率分别为43.7%、71.9%、78.1%;9.4%、56.3%、68.8%;6.3%、40.6%、46.9%;62.5%、78.1%、93.8%。结论阿德福韦酯治疗慢性乙型肝炎疗效欠佳者换用替比夫定后取得显著抗病毒疗效并较快恢复肝功能,无不良反应。
Objective To explore the efficacy of adefovir dipivoxil in the treatment of patients with chronic hepatitis B who have not responded to telbivudine. Methods 32 cases of adefovir dipivoxil treatment of chronic hepatitis B patients with poor efficacy continue to use conventional liver protection drugs based on the use of telbivudine 600mg orally, 1 / d. HBVM, HBV-DNA and liver function were detected in the 3rd, 6th and 12th month respectively, and the curative effect was observed before and after treatment. Results After adefovir dipivoxil treatment for patients with chronic hepatitis B, the HBV-DNA negative rate, HBeAg negative rate, HBeAb negative rate and ALT normal at 3, 6 and 12 months after switching to telbivudine Rates were 43.7%, 71.9%, 78.1%, 9.4%, 56.3%, 68.8%, 6.3%, 40.6%, 46.9%, 62.5%, 78.1%, 93.8% respectively. Conclusion adefovir dipivoxil treatment of chronic hepatitis B patients with poor response to telbivudine obtained significant antiviral efficacy and rapid recovery of liver function, no adverse reactions.