阿德福韦酯治疗失败的慢性乙型肝炎两种挽救治疗方案比较

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Abstract Objective To compare the clinical efficacy and safety of tenofovir disoproxil fumarate(TDF) monotherapy and entecavir(ETV) monotherapy in chronic hepatitis B patients with treatment failing to adefovir dipivoxil(ADV)therapy.Methods A total of 120 chronic hepatitis B patients with of ADV failure were investigated, and randomly divided into equally two groups. Sixty patients with chronic hepatitis B on rescue treatment with TDF(300 mg/d) monotherapy for 48 weeks served as group A were analyzed retrospectively.The serum HBV DNA levels,HBeAg,ALT and serum creatinine(Cr) were evaluated at weeks 0,12,24,48. In addition,data of 60 patients treated with ETV(0.5 mg/d) monotherapy for 48 weeks serving as group B were also collected.Results After 48 weeks follow-up,the virological response(VR) rate were 63.3％(38/60) in group A and 78.3％(47/60) in group B,respectively,and P value less than 0.05 when the two groups were compared. But the ALT normalization rate,seroeonversion rate (from HBeAg to HBeAb),the virologic breakthrough(VB) rate were 57.8％ (26/45),13.6% (6/44),0 in group A,respectively.Meanwhile,in group B,they were 60.4％(29/48),14.9% (7/47),0,respectively with P value not showing significant difference between the two groups. Both groups showed comparable tolerance and not found elevated Cr at the end of treatment.Conclusions The therapy of ETV monotherapy is an effective and safe therapeutic strategy for chronic hepatitis B patients with a treatment failing to ADV therapy,and is superior to TDF monotherapy rescue strategy.

Key words： chronic hepatitis B adefovir dipivoxil entecavir tenofovir disoproxil fumarate rescue treatment

Received: 11 August 2015

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	LI Zhongbin
	SHAO Qing
	XIA Jing
	LI Bing
	LI Fan
	A Erxin
	CHEN Songhai
	WANG Chunyan
	and CHEN Guofeng

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LI Zhongbin,SHAO Qing,XIA Jing等. Comparison of efficacy of two kinds of rescuing treatments in chronic hepatitis B patients with treatment failing to adefovir dipivoxil therapy[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(3): 253-256.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2016/V27/I3/253

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