恩替卡韦与阿德福韦酯联合拉米夫定治疗HBeAg阳性慢性乙型肝炎的效果分析  

Effect analysis of entecavir and adefovir ester combined with lamivudine in treating HBeAg-positive chronic hepatitis B

作　　者：尹丹萍[1] 韩玮[2] Yin Danping;Han Wei(Department of Disease Prevention and Control,Department of Medical Administration,General Hospital of Jinan Military Command,Jinan 250031,China;Department of Science and Training,Department of Medical Administration,General Hospital of Jinan Military Command,Jinan 250031,China)

机构地区：[1]济南军区总医院疾病预防控制科,250031 [2]济南军区总医院医务部科训科,250031

出　　处：《中华消化病与影像杂志（电子版）》2018年第2期53-56,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：2015年度济南军区总医院院长基金(2015QN02)

摘　　要：目的比较抗乙型肝炎病毒药物恩替卡韦(ETV)与阿德福韦酯(ADV)联合拉米夫定(LAM)对治疗HBeAg阳性慢性乙型肝炎患者的疗效与安全性。方法选择济南军区总医院2012年7月至2015年7月HBeAg阳性慢性乙型肝炎患者110例,随机分为恩ETV组50例,ADV+LAM组60例,随访观察治疗48、96周后HBV-DNA转阴率,HBeAg血清学转换率,丙氨酸转氨酶(ALT)复常率及不良事件发生率。结果治疗HBeAg阳性的慢性乙型肝炎结果显示,2组患者进行治疗48和96周后,在HBV-DNA转阴率(ETV比ADV+LAM:48周20比15;96周35比45)及ALT复常方面(ETV比ADV+LAM:48周40比44;96周48比56)均有效,但无明显差异(P>0.05);在HBeAg转阴率方面在随访前48周时,二者未见明显差异,但随着口服时间延长,ETV组转阴率明显高于ADV+LAM组(ETV比ADV+LAM:48周10比8;96周18比9)。结论恩替卡韦与阿德福韦酯联合拉米夫定在治疗HBeAg阳性的慢性乙型肝炎患者中,随访时间越长恩替卡韦HBeAg转阴作用越显著,药物的安全性较高。Objective To compare the effect and safety of entecavir(ETV)and adefovir ester combined with lamivudine(ADV+LAM)for HBeAg-positive chronic hepatitis B(CHB).Methods A total of 110 HBeAg-positive CHB patients were selected in General Hospital of Jinan Military Command from July 2012 to July 2015,and they were randomly divided into ETV group(50 cases)and ADV+LAM group(60 cases).The HBV-DNA negative conversion ratio,HBeAg seroconversion rate,alanine aminotransferase(ALT)recovery rate and adverse event rate were observed 48 and 96 weeks after treatment.Results The HBV-DNA negative conversion ratio(ETV vs.ADV+LAM:48 weeks 20 vs.15,96 weeks 35 vs.45)and ALT recovery rate(ETV vs.ADV+LAM:48 weeks 40 vs.44,96 weeks 48 vs.56)of the two groups were both improved 48 and 96 weeks after treatment,but the difference was not statistically significant(P>0.05).The difference of the HBeAg seroconversion rate between the two groups was not statistically significant for the first 48 weeks(ETV vs.ADV+LAM:48 weeks 10 vs.8).As time went on,the HBeAg seroconversion rate of ETV group was higher than that of ADV+LAM group(96 weeks 18 vs.9).Conclusion In the treatment of HBeAg-positive CHB patients using ETV and ADV+LAM,the more remarkable effect of HBeAg seroconversion rate of ETV is correlated with the longer follow-up,and the drug is safer.

关 键 词：乙型肝炎 HBEAG阳性 恩替卡韦 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]