替诺福韦酯和恩替卡韦对慢性乙型肝炎初治患者疗效的荟萃分析  

A meta-analysis of comparison of efficacy of tenofovir or entecavir in nucleos(t)ide analogue-naive patients with chronic hepatitis B

作　　者：丁荣蓉[1] 施光峰[2] 张占卿[1] 周新兰[1] DING Rong-rong SHI Guang-feng ZHANG Zhan-qing ZHOU Xin-lan(Division Two of theHepatitis Department , Shanghai Public Health Clinical Center, Shanghai 201505, China)

机构地区：[1]上海市公共卫生临床中心,201508 [2]复旦大学附属华山医院感染科

出　　处：《肝脏》2017年第5期400-403,共4页Chinese Hepatology

摘　　要：目的评价替诺福韦酯(TDF)和恩替卡韦(ETV)对慢性乙型肝炎(CHB)初治患者抗病毒的疗效及安全性。方法对2006年1月至2016年10月在国际生物医学期刊有关TDF和ETV治疗CHB的临床研究进行质量评价,并对相关文献进行荟萃分析。结果共纳入6篇文献。荟萃分析结果显示ETV和TDF抗病毒治疗的HBV DNA转阴率差异无统计学意义[48周时的RR=1.19,95%CI=1.09~1.30;96周时的RR=1.08,95%CI=1.02~1.14];两种药物的ALT复常率及HBeAg血清学转换率同样差异无统计学意义;且两种药物长期使用安全性良好,未观察到严重不良反应。结论 ETV和TDF对CHB核苷(酸)类药物初治患者抗病毒疗效相似,但仍需进一步观察远期治疗的安全性。Objective To compare treatment efficacy and safety of tenofovir（TDF） or entecavir（ETV） in nucleoside-nave chronic hepatitis B（CHB） patients using meta-analysis.Methods Published data relevant to TDF or ETV treated CHB patients from January 2006 to October 2016 was enrolled and meta-analyzed.The rate of Hepatitis B virus（HBV） DNA suppression,alanine transaminase（ALT） normalization,and hepatitis B e antigen（HBeAg） seroconversion at week 48 and 96 were reviewed,respectively.Drug safety and resistance were also discussed.Results There were 6 articles involved.The meta-analysis showed no significant differences in HBV DNA suppression rate between the two drugs in nave treated CHB patients（TDF vs.ETV：RR=1.19,95%CI=1.09-1.30 and RR=1.08,95%CI=1.02-1.14 for week 48 and week 96,respectively）.Moreover,there were also no differences in ALT normalization rate（4 studies for 48 weeks）,HBeAg seroconversion rate（3 studies for 96 weeks） and long-term safety between TDF and ETV,respectively.Conclusion TDF and ETV show similar efficacy in treating nucleoside-nave chronic HBV patients.Nevertheless,the longterm efficacy and safety should be monitored in prolonged therapy.

关 键 词：慢性乙型肝炎 恩替卡韦 替诺福韦酯 META分析 

分 类 号：R512.62[医药卫生—内科学]