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J Viral Hepat:对阿德福韦单一治疗应答不佳,再使用以阿德福韦为基础的联合治疗后的有效性和安全性

2017-11-26 MedSci MedSci原创

相比LAM + ADV 和ETV + ADV组,LdT + ADV组患者eGFR有一定改善。 研究结论:这三种组合策略都能很好地控制病毒的复制,但是LdT + ADV联合治疗可能会提高HBeAg血清转化和改善eGFR。

研究背景:虽然强效核苷酸类似物被推荐作为抗病毒的一线药物,但是一些患者仍然使用阿德福韦酯进行治疗,尤其是在低收入家庭。在中国,阿德福韦酯治疗失败的患者和在使用阿德福韦酯治疗过程中,发生肾脏损害的患者,对他们的管理仍然是一个难题。


研究方法:本研究是一项回顾性研究,旨在比较拉米夫定(LAM),替比夫定(LdT)和恩替卡韦(ETV)联合治疗策略的疗效和安全性,以优化患者ADV单药治疗不佳反应的治疗。277例患者纳入本研究,LAM + ADV (n = 116),LdT + ADV (n = 72) 和 ETV + ADV (n = 89) 组,3组基线患者的临床特性相似。

研究结果:96周,LAM + ADV,LdT + ADV,ETV + ADV3组未检出HBV DNA的比例分别是81.03%,84.72%,88.76;AM + ADV,LdT + ADV,ETV + ADV3组ALT水平增加的比率分别是5.17%,4.17%,4.49%。从基线到96周,3组患者肝硬度显著下降。96周时,相比LAM + ADV组和ETV + ADV,LdT + ADV组HBeAg血清学转换比率最高。在96周过程中,3组均未有肾损伤的报导;相比LAM + ADV 和ETV + ADV组,LdT + ADV组患者eGFR有一定改善。

研究结论:这三种组合策略都能很好地控制病毒的复制,但是LdT + ADV联合治疗可能会提高HBeAg血清转化和改善eGFR。

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    2018-05-15 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

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    2017-11-28 gwc384
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