摘要
目的观察比较恩替卡韦与替比夫定治疗e抗原阳性慢性乙型肝炎患者的近期疗效。方法将60例HBeAg阳性慢性乙型肝炎患者随机分为恩替卡韦组和替比夫定组,每组各30例,分别检测治疗前、治疗12周和24周时患者血清HBV DNA定量、HBV血清标志物及肝功能。结果治疗12周时,恩替卡韦和替比夫定组患者HBVDNA低于检测值的比例分别为76.7%和36.7%(P<0.01);HBVDNA较基线下降≥3log10copy/ml比例分别为90.0%和66.7%(P<0.05),HBV DNA降幅分别为(5.60±1.96)log10copy/ml和(4.47±1.41)log10copy/ml(P<0.05);HBeAg转阴率分别为46.7%与20.0%(P<0.05);HBeAg血清学转换率分别为36.7%和13.3%(P<0.05);ALT复常率分别为73.3%和53.3%(P>0.05)。治疗24周时,两组HBV DNA低于检测值的比例分别为70.0%和60.0%(P>0.05);HBV DNA较基线下降≥3log10copy/ml比例分别为100.0%和80.0%(P<0.05);HBV DNA降幅分别为(5.60±1.68)log10copy/ml和(5.60±2.10)log10copy/ml(P>0.05);HBeAg转阴率分别为33.3%与26.7%(P>0.05);HBeAg血清学转换率分别为20.0%和26.7%(P>0.05);ALT复常率分别为90.0%和73.3%(P>0.05)。24周综合疗效评价两组差异无统计学意义(P>0.05)。除替比夫定组有1例出现临床耐药外,两组均未发生严重不良反应。结论恩替卡韦与替比夫定治疗HBeAg阳性慢性乙型肝炎的近期ALT复常率和综合疗效评价差异无统计学意义;12周时恩替卡韦抑制HBV DNA能力、HBeAg转阴率和HBeAg血清学转换率高于替比夫定,但24周时两组间差异基本无统计学意义。
Objective To evaluate the efficacy and safety of entecavir versus telbivudine treatments in patients with HBeAg-positive chronic hepatitis B.Methods Sixty patients with HBeAg-positive chronic hepatitis B were divided into two groups： entecavir treatment group（n=30）,and telbivudine treatment group（n=30）.Line serum samples were collected for measuring HBV DNA,HBV markers and ALT at baseline,week 12 and week 24.Results At week 12,the rate of undetectable HBV DNA in patients were 76.7% and 36.7%（P〈0.01） in entecavir group and telbivudine group respectively.The proportions of HVB DNA decreased ≥ 3log10copy/ml were 90.0% and 66.7%.The reduction magnitude of HBV DNA were（5.60±1.96）log10copy/ml and（4.47±1.41） log10copy/ml respectively（P〈0.05）.The proportions of patients with HBeAg-negtive were 46.7% and 20.0%（P〈0.05）,and with HBeAg seroconversion were 36.7% and 13.3%（P〈0.05） in the two groups respectively.Recovery rate of ALT were 73.3% and 53.3% respectively.At week 24,The rate of undetectable HBV DNA in patients were 70.0% and 60.0%（P〉0.05） in entecavir group and telbivudine group respectively.The proportions of HVB DNA decreased ≥ 3log10copy/ml were 100.0% and 80.0%（P〈0.05）.The reduction magnitude of HBV DNA were（5.60±1.68）log10copy/ml and（5.60±2.10） log10copy/ml（P〉0.05）.The proportions of patients with HBeAg-negtive were 33.3% and 26.7%（P〈0.05）,and with HBeAg seroconversion were 20.0% and 26.7%（P〈0.05） in the two groups respectively.Recovery rate of ALT were 90.0% and 73.3% respectively.There was no significant difference between the two groups at week 24（P〉0.05）.No adverse reactions were found in either group except 1 case drug resistance in telbivudine treatment group.Conclusion There was no significant difference in HBV DNA undetectable rates and the ALT normalization rates between the two groups in a short-term therapy（24 weeks）,but the entecavir group had a higher rate in HBV DNA undetectable rates and HBeAg-negtive and HBeAg seroconversion rates than that in the telbivudine group at week 12.
出处
《临床军医杂志》
CAS
2011年第1期14-16,共3页
Clinical Journal of Medical Officers
