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摘要: 目的探讨阿德福韦酯(ADV)单用或联合拉米夫定治疗YMDD变异的慢性乙型肝炎(CHB)的疗效及安全性。方法40例研究对象随机分为ADV组(20例)和联合组(20例),分别换用或加用ADV片10mg/d治疗。结果两组ALT、AST、TBil值在治疗1、2年时分别与同组治疗前比较差异均极显著(P<0.01),1年时两组间比较差异无显著(P>0.05);治疗2年时联合组ALT、AST值显著低于ADV组(P<0.01),两组TBil值差异无显著(P>0.05)。两组HBV DNA转阴、ALT复常、耐药率在治疗1年时差异均无显著(P>0.05),2年时差异显著(P<0.05);两组HBeAg转阴率及血清转换率治疗1、2年时比较差异均无显著(P>0.05);治疗过程中两组均无严重不良事件发生。结论ADV联合拉米夫定治疗YMDD变异CHB在病毒学、生化学方面长期疗效优于单用ADV治疗,近期疗效相似,前者耐药发生率低,两组安全性均良好。
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