LdT和ETV治疗HBeAg阳性CHB患者的HBeAg血清转换率  

The cumulative rate of HBeAg seroconversion in HBeAg positive chronic hepatitis B patients treated with telbivudine and entecavir after propensity score matching

作　　者：刘友德 刘锦屏 华正中 王春娟 强春倩 邹志强 于吉广 

机构地区：[1]烟台市传染病医院肝病科七病区,264001 [2]烟台市传染病医院肝病科八病区,264001 [3]烟台市传染病医院肝病科二病区,264001

出　　处：《中华实验和临床病毒学杂志》2015年第4期326-328,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的经倾向性评分匹配法（PSM）均衡组间协变量后，比较替比夫定（LdT）与恩替卡韦（ETV）治疗的HBeAg阳性CHB患者的HBeAg血清转换率。方法回顾性分析2009年12月至2014年5月我院接受替比夫定或者恩替卡韦治疗的HBeAg阳性CHB患者的临床资料，使用SPSS软件PSM功能对两组患者进行匹配，得到组间协变量均衡的样本，并用新样本作统计学处理。结果两组共56对匹配成功，替比夫定治疗组和恩替卡韦治疗组2年的HBeAg血清学转换累积发生率分别为28．6％和14．8％；4年的HBeAg血清学转换累积发生率分别为42．0％和39．3％（LogRanktest χ2=4．469P=0．035）。Cox回归分析显示，替比夫定治疗、低基线HBeAg水平是接受替比夫定和恩替卡韦治疗的HBeAg阳性的CHB患者2年HBeAg血清学转换的独立预测因素（均P〈0．05）。结论应用PSM能有效提高非随机资料组间协变量的均衡性；替比夫定治疗的HBeAg阳性慢性乙型病毒性肝炎患者2年的HBeAg血清转换率高于恩替卡韦，4年的HBeAg血清学转换率2组类似。Objective To compare the cumulative rate of HBeAg seroconversion in HBeAg positive chronic Hepatitis B patients treated with telbivudine and entecavir after Propensity Score Matching. Methods CHB patients who accepted telbivudine or entecavir from Dec 2009 to May 2014 were retrospectively collected. PSM function of SPSS software was conducted to reduce confounding bias between the groups. And then survival analysis was performed for the matched data. Results 56 pairs of patients were successfully matched. The 2-year cumulative rate of HBeAg seroconversion were 28.6% and 14.8% in the telbivudine group and entecavir group, which were 42.0% and 39.3% in the fourth year respectively. Cox regression analysis revealed that telbivudine therapy, low HBeAg level at baseline were independent predict factors of HBeAg seroconversion（P 〈 0.05）. Conclusions The balance of covariates may be achieved through PSM. The 2-year cumulative rate of HBeAg seroconversion in the telbivudine group is higher than entecavir group, while they are similar in the 4th year.

关 键 词：评价研究 替比夫定 恩替卡韦 肝炎E抗原 乙型 血清流行病学研究 

分 类 号：R512.62[医药卫生—内科学]