Objective To observe the efficacy of entecavir combined with adefovir dipivoxil in the treatment of HBeAg negative patients with chronic hepatitis B .Methods A total of 200 HBeAg negative patients with chronic hepatitis B was equally randomized into two groups of A and B .The patients in group A were treated with entecavir 0.5 mg/d orally and those in group B were treated with entecavir combined with adefovir dipivoxil 10 mg/d orally .T cell subsets and the levels of HBV DNA ,ALT ,AST and TBil were compared between two groups after treated for three months .The therapy-related adverse effects were recorded as well .Results The levels of HBV DNA ,ALT ,AST and TBil were lower after treatment than those before in both groups (P<0 .05) .The levels of AST , TBil and HBV DNA were lower in group B than those in group A after treatment (P<0 .05) .The percentage of CD4+ cells and CD4+ /CD8+ ratio were higher and the percentage of CD8+ cells was lower in group B than those in group A after treatment (P<0 .05) .The total effectiveness rate was higher in group B than that in group A (98.0% vs .82.0% )(P<0 .05) .There were no significant differences in the adverse effects between two groups (P>0 .05) .Conclusion Compared to entecavir alone in the treatment of HBeAg negative patients with chronic hepatitis B ,entecavir combined with adefovir dipivoxil is more effective in improving the cellular immune function and clinical efficacy without an increase of adverse effects .%目的 观察恩替卡韦联合阿德福韦酯治疗HBeAg阴性慢性乙型肝炎患者的疗效.方法 未经抗病毒治疗的HBeAg阴性慢性乙型肝炎患者200例,随机均分为两组:对照组给予恩替卡韦0.5 mg/d口服治疗;观察组加用阿德福韦酯10 mg/d口服治疗.治疗3个月后,比较两组T细胞亚群、HBV DNA、ALT、AST和TBil水平,记录不良反应发生情况.结果 两组治疗后,ALT、AST、TBil、HBV DNA水平均低于治疗前(P<0.05),观察组治疗后AST、TBil、HBV DNA水平低于对照组(P<0.05).治疗后,观察组外周血CD4+细胞比率和CD4+/CD8+均高于对照组,CD8+细胞比率低于对照组(P<0.05).治疗3个月,观察组总有效率高于对照组(98.0%vs.82.0%)(P<0.05),两组不良反应发生率差异无统计学意义(P>0.05).结论 与单用恩替卡韦比较,恩替卡韦联合阿德福韦酯治疗HBeAg阴性慢性乙型肝炎患者更能改善患者细胞免疫功能,提高临床疗效,且不增加不良反应的发生率.
展开▼
