[1]刘小莹,郑宏波,王山军△,等.恩替卡韦单药方案维持对初始行拉米夫定+阿德福韦酯方案治疗慢性乙型肝炎及慢性乙型肝炎后肝硬化疗效影响[J].陕西医学杂志,2020,49(4):502-505.
　LIU Xiaoying,ZHENG Hongbo,WANG Shanjun,et al.Influence of maintenance of entecavir monotherapy regimen on clinical effect of initial lamivudine plus adefovir dipivoxil regimen in the treatment of chronic hepatitis B and cirrhosis after chronic hepatitis B[J].,2020,49(4):502-505.
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恩替卡韦单药方案维持对初始行拉米夫定+阿德福韦酯方案治疗慢性乙型肝炎及慢性乙型肝炎后肝硬化疗效影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年4期
页码:
502-505
栏目:
药物与临床
出版日期:
2020-04-05

文章信息/Info

Title:
Influence of maintenance of entecavir monotherapy regimen on clinical effect of initial lamivudine plus adefovir dipivoxil regimen in the treatment of chronic hepatitis B and cirrhosis after chronic hepatitis B
文章编号:
DOI:10.3969/j.issn.10007377.2020.04.029
作者:
刘小莹; 郑宏波; 王山军△; 王一龙
陕西省咸阳市中心医院传染科(咸阳712000)
Author(s):
LIU Xiaoying; ZHENG Hongbo; WANG Shanjun; et al.
Department of Infectious Diseases,Xianyang Central Hospital,Shaanxi Province(Xianyang 712000)
关键词:
慢性乙型肝炎;  肝硬化;  恩替卡韦;  拉米夫定;  阿德福韦酯;  病毒应答
Keywords:
Chronic hepatitis B;  Cirrhosis;  Entecavir hydrate;  Lamivudine;  Adefovir dipivoxil;  Viral response
分类号:
R575.1
文献标志码:
A
摘要:
目的:探讨恩替卡韦(ETV)单药方案维持对初始行拉米夫定+阿德福韦酯(LAM+ADV)方案治疗慢性乙型肝炎(CHB)及CHB后肝硬化患者疗效的影响。方法:收集CHB及CHB后肝硬化患者共475例,将治疗1年后仍采用LAM+ADV方案维持患者共273例设为对照组,改为ETV单药方案维持患者202例设为观察组; 比较两组病毒学应答效果、耐药发生率、血清肌酐(Scr)、肾小球滤过率(eGFR)及尿微量白蛋白变化情况。结果:观察组随访2年和3年HBV-DNA水平低于检测下限比例均显著高于对照组(P<0.05); 观察组随访2年和3年耐药发生率均显著低于对照组(P<0.05); 观察组随访2年和3年Scr较基线升高>50 μmol/L比例均显著低于对照组(P<0.05); 观察组随访1年、2年及3年eGFR较基线下降<30%比例均显著低于对照组(P<0.05); 同时观察组随访1年、2年及3年β2微球蛋白异常和视黄醇结合蛋白异常比例均显著低于对照组(P<0.05)。结论:ETV单药方案维持用于初始行LAM+ADV方案CHB及CHB后肝硬化患者可有效提高病毒应答效果,避免耐药发生,并有助于保护肾脏功能,价值优于LAM+ADV方案维持。
Abstract:
Objective:To investigate the influence of maintenance of ETV monotherapy regimen on clinical efficacy of initial LAM+ADV regimen of patients with CHB and post-CHB cirrhosis.Methods:A total of 475 patients with CHB and post-CHB cirrhosis were chosen and divided into control group(273 patients who continued to receive LAM+ADV regimen maintenance after 1 year of treatment )and observation group(202 patients who switched to ETV monotherapy maintenance after 1 year of treatment).The virological response,incidence of drug resistance,and changes levels of Scr,eGFR and urinary microalbumin were compared between two groups.Results:The proportion of HBV-DNA levels below the detection limit during 2 and 3 years of followed-up in observation group were significantly higher than those in control group(P<0.05).The incidence of drug resistance during 2 and 3 years of followed-up in observation group were significantly lower than those in control group(P<0.05).The proportion of Scr increased > 50 μmol/L from baseline during 2 and 3 years of followed-up in observation group were significantly lower than those in control group(P<0.05).The proportion of eGFR decreased < 30% from baseline during 1,2 and 3 years of followed-up in observation group were significantly lower than those in control group(P<0.05).The proportion of abnormal β2 microglobulin and abnormal retinol binding protein during 1,2 and 3 years of followed-up in observation group were significantly lower than those in control group(P<0.05).Conclusion:Compared with LAM+ADV regimen,maintenance of ETV monotherapy regimen in the treatment of initial LAM+ADV regimen of patients with CHB and post-CHB cirrhosis can effectively improve viral response effects,avoid the occurrence of drug resistance and be helpful to protect renal function.

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更新日期/Last Update: 2020-04-13