摘要:目的: 观察拉米夫定联合阿德福韦酯治疗E抗原阴性的慢性乙型肝炎患者的疗效和安全性。 方法 :2006～2007年来我院就诊的慢性乙型肝炎患者,给予拉米夫定100 mg/d,阿德福韦酯 100 mg/d,观察治疗前及治疗后12、24 及48周谷丙转氨酶水平、HBV DNA水平、乙型肝炎病毒血清标志物的应答效果及肾功能变化。 结果 :治疗12周、24周和48周时,HBV DNA转阴率分别为17%、43%和87%,且各组间差异具有统计学意义(P lt;005);ALT复常率分别为13%,67%和100%,且各组间差异具有统计学意义(P lt;005);治疗48周时,所有患者均未发生表面抗原的消失;整个治疗过程中,患者的耐受性良好,未发生一例严重不良事件。 结论 :拉米夫定联合阿德福韦酯治疗E抗原阴性的慢性乙肝患者,可获得较好的临床疗效,该治疗策略为临床抗病毒治疗提供了新的选择。Abstract: Objective: To observe the curative efficacy and safety of lamivudine combined with adefovir dipivoxil on HBeAgnegative initial treated chronic hepatitis B (CHB) patients. Methods : Outatients from our hospital between June, 2006 and August, 2007, who received lamivudine 100 mg and adefovir dipivoxil 10 mg per day were screened. And the level of ALT, HBV DNA, and urea nitrogen, as well as the statue of HBsAg and antiHBs were detected at week 12, 24, and 48 Results : The undetectable rates of HBV DNA were 17%, 43%, and 87% at week 12, 24, and 48 respectively, and the difference in response rate were statistic significantly (Plt;005). The ALT normalization rate were 13%, 67%, and 100% at week 12, 24, and 48 respectively, and the difference in response rate were statistic significantly (Plt;005); During the course of antiviral therapy, the loss of HBsAg was not observed and all patients were well tolerated. Conclusion : The combination of lamivudine and adefovir dipivoxil were effective for HBeAgnegative CHB patients, and this treatment strategy provided us a new option in clinical antiviral practice.