摘要
目的比较富马酸替诺福韦酯与恩替卡韦治疗慢性乙型肝炎(乙肝)初治患者疗效与安全性。方法回顾性分析100例慢性乙肝患者病历资料,其中接受富马酸替诺福韦酯和恩替卡韦治疗各50例。检测、比较治疗前和治疗后24、48周两组患者HBVDNA水平、HBVDNA阴转率、HBeAg阴转率和ALT复常率,观察随访期间不良反应发生情况。结果两组患者年龄构成、性别构成、随访时间、饮酒者比例、吸烟者比例、乙肝家族史比例、治疗前ALT值、治疗前HBVDNA水平及HBeAg阳性比例差异均无统计学意义(P>0.05)。治疗后24、48周,两组患者HBVDNA水平均较治疗前显著下降(P<0.01),但两组间差异均无统计学意义(P>0.05)。治疗后24、48周,两组患者HBV DNA阴转率均>50%,ALT复常率均>80%,且两组患者HBVDNA阴转率、HBeAg阴转率和ALT复常率间差异均无统计学意义(P>0.05)。治疗期间,均未发生严重不良反应。结果富马酸替诺福韦酯和恩替卡韦可快速、有效抑制HBV DNA复制,且药物不良反应发生皋低,是治疗慢性乙肝初治患者的安全.有效抗病毒药。
Objective To compare the efficacy and safety of tenofovir disoproxil fumarate and entecavir for treatment-na?ve patients with chronic hepatitis B.Methods The medical records of 100 patients with chronic hepatitis B were retrospectively reviewed,including 50 cases undergoing tenofovir disoproxil fumarate treatment and 50 cases with ente-cavir therapy.The HBV DNA level,negative conversion rate of HBV DNA,negative conversion rate of HBeAg and renormalization rate of ALT were detected and compared between the two groups prior to treatment and 24 and 48 weeks post-treatment.In addition,the treatment induced adverse reactions were observed during the follow up period.Results There were no significant differences between the two groups in terms of age,gender,follow-up duration,proportion of alcohol consumption,proportion of smoking,proportion of family history with hepatitis B,pre-treatment ALT concen-tration,pre-treatment HBV DNA level or proportion of HBeAg positivity(P>0.05).The HBV DNA levels significantly reduced in patients with tenofovir disoproxil fumarate(at 24 weeks,1.8±1.1 vs.6.5±0.4 logl0 IU/mL,P<0.01;at 48 weeks,1.4±0.3vs.6.5±0.4 log10 IU/mL,P<0.01)and entecavir therapy(at 24 weeks,1.9±0.9vs.6.4±0.7 log10 IU/mL,P<0.01;at 48 weeks,1.4±0.4 vs.6.4±0.7 log10 IU/mL,P<0.01)24 and 48 weeks post-treatment than pre treatment;however,no significant differences were seen between the two groups(P>0.05).The negative conversion rates of HBV DNA were all higher than 50%and the ALT renormalization rates were all greater than 80%in the two groups 24 and 48 weeks post-treatment;however,there were no significant differences found be-tween the two groups in terms of negative conversion rates of HBV DNA(at 24 weeks,52%vs.54%,P>0.05;at 48 weeks,78%vs.82%,P>0.05),negative conversion rates of HBeAg(at 24 weeks,9,7%vs.7.4%,P>0.05;at 48 weeks,16.1%vs.18.5%,P>0.05)or ALT renormalization rate(at 24 weeks,80%vs.82%,P>0.05;at 48 weeks,100%vs.100%,P>0.05).During the follow-up period,no severe adverse reactions were found.Conclusion Both tenofovir disoproxil fumarate and entecavir are rapid and effective to inhibit HBV DNA replication with a low inci-dence of adverse reactions,which are both safe and active for the treatment-na?ve patients with chronic hepatitis B.
作者
蒋亚萍
JIANG Ya-ping(Department of Pharmacy»Zhenjiang Third People's Hospital,Zhenjiang 212021,Jiangsu,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第12期1464-1466,共3页
Journal of Pathogen Biology
