恩替卡韦和替比夫定初始治疗慢性乙型肝炎的疗效及安全性  

Efficacy of entecavir and telbivudine in treating chronic hepatitis B

作　　者：王立玮[1] 王立蓉[1] 蔡莉静[1] 

机构地区：[1]南京市第二医院消化病科,江苏省210003

出　　处：《江苏医药》2016年第11期1244-1246,共3页Jiangsu Medical Journal

摘　　要：目的评价恩替卡韦(ETV)和替比夫定(LdT)初始治疗慢性乙型肝炎(CHB)的疗效及安全性。方法 118例CHB患者分别采用ETV(ETV组,60例)和LdT(LdT组,58例)治疗48周,检测治疗前和治疗第12、24、36、48、72和96周的HBV DNA阴转率、ALT复常率和HBeAg转换率等相关指标。结果治疗第12、24和36周时,ETV组的HBV DNA阴转率分别为81.7%、83.3%和86.7%,高于LdT组的53.4%、58.6%和62.1%(P<0.05)。两组患者治疗过程中ALT复常率相仿(P>0.05)。治疗第24、36和48周时,ETV组的HBeAg转换率分别为6.3%、12.5%和18.8%,低于LdT组28.6%、39.3%和50.0%(P<0.05)。两组治疗期间未发现明显不良反应。结论ETV治疗CHB患者较LdT能更快、更强抑制HBV复制。LdT治疗具有更高的血清学转换率。Objective To compare the clinical efficacy and safety of entecavir（ETV）and telbivudine（LdT）in the treatment of patients with chronic hepatitis B（CHB）.Methods A total of118 patients with CHB was treated with ETV（group A,60cases）or LdT（group B,58cases）for 48 weeks.The relevant indicators of HBV DNA negative conversion rate,serum ALT normalization rate,and HBeAg seroconversion rate,etc.were determined before and in the 12^th,24^th,36^th,48^th,72^th and96^th week during treatment.Results In the 12^th,24^th,and 36^th week during treatment,the rates of HBV DNA negative conversion in group ETV were 81.7%,83.3% and 86.7%,respectively,which were higher than 53.4%,58.6% and 62.1%in group LdT（P〈0.05）.The ALT normalization rates of both groups were similar during treatment（P〉0.05）.In the 24^th,36^th and 48^th week during treatment,the HBeAg seroconversion rates in group ETV were 6.3%,12.5% and 18.8%,respectively,which were lower than 28.6%,39.3% and 50.0%in group LdT（P〈0.05）.No obvious adverse effects were seen during treatment in both groups.Conclusion ETV therapy has better suppressive effect on HBV DNA copy than LdT.LdT therapy has better effect on serum HBeAg normalization than ETV.

关 键 词：慢性乙型肝炎 恩替卡韦 替比夫定 

分 类 号：R512[医药卫生—内科学]