恩替卡韦与替诺福韦对HBeAg阳性初治慢性乙型肝炎患者的疗效及安全性分析  

Analysis of the Efficacy and Safety of Entecavir and Tenofovir in the Treatment of HBe Ag Positive Initial Chronic Hepatitis B Patients

作　　者：林文武 余雪平 郑怡娟 郭如意[1] 苏智军[1] LIN Wenwu;YU Xueping;ZHENG Yijuan;GUO Ruyi;SU Zhijun(Quanzhou First Hospital,Quanzhou 362000,China)

机构地区：[1]泉州市第一医院,福建泉州362000

出　　处：《中外医学研究》2020年第28期55-57,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:评价恩替卡韦与替诺福韦对HBeAg阳性初治慢性乙型肝炎患者的疗效及安全性。方法:选取2017年6月-2018年6月在本院收治的80例HBeAg阳性初治慢性乙型肝炎患者为研究对象,按随机数字表法分组方式,将其分为对照组与观察组,每组40例。对照组使用恩替卡韦进行治疗,观察组使用替诺福韦进行治疗,对两组患者治疗12、24个月后的HBV-DNA水平、ALT复常率、HBeAg血清学转换率、HBeAg血清学转阴率及用药安全性进行比较。结果:治疗12个月后,两组患者的HBV-DNA水平、ALT复常率、HBeAg血清学转换率、HBeAg血清学转阴率比较差异均无统计学意义(P>0.05);治疗24个月后,观察组患者的HBV-DNA水平明显低于对照组,ALT复常率、HBeAg血清学转换率、HBeAg血清学转阴率高于对照组,差异均有统计学意义(P<0.05);治疗结束后,两组患者未出现副作用及耐药情况;观察组的肾小球滤过率高于对照组,差异有统计学意义(P<0.05)。结论:HBeAg阳性初治慢性乙型肝炎患者以替诺福韦治疗,可有效改善患者的肝功能,提高ALT复常率、HBeAg血清学转换率及转阴率,且不会对患者肾功能产生影响,安全性高,值得在临床中推广应用。Objective:To evaluate the efficacy and safety of Entecavir and Tenofovir in the treatment of HBeAg Initial positive chronic hepatitis B patients.Method:From June 2017 to June 2018,80 cases of HBeAg positive initial diagnosed chronic hepatitis B patients in our hospital were selected as the research objects.According to the random number table method,80 patients were divided into the control group and the observation group,40 cases in each group.The control group was treated with Entecavir,and the observation group was treated with Tenofovir.After 12 months and 24 months of treatment,HBV-DNA level,ALT normalization rate,HBeAg seroconversion rate,HBeAg seroconversion rate and drug safety were compared.Result:After 12 months of treatment,there were no significant differences in HBV-DNA level,ALT normalization rate,HBeAg seroconversion rate,HBeAg seroconversion rate (P>0.05).After 24 months of treatment,the HBV-DNA level of the observation group was significantly lower than that of the control group,ALT normalization rate,HBeAg seroconversion rate and HBeAg seroconversion rate were higher than those in the control group,there were statistically significant differences (P<0.05).After the treatment,there were no side effects and drug resistance in the two groups.The glomerular filtration rate of the observation group was higher than that of the control group,the difference was statistically significant (P<0.05).Conclusion:Tenofovir was used to treat HBeAg positive patients with initial diagnosed chronic hepatitis B,it can effectively improve the liver function of patients,improve the normalization rate of ALT,HBeAg seroconversion rate and negative conversion rate,and will not affect the renal function of patients,with high safety,which is worthy of clinical application.

关 键 词：恩替卡韦 替诺福韦 HBEAG阳性 慢性乙型肝炎 初次治疗 

分 类 号：R512.62[医药卫生—内科学]