不同种类核苷类似物治疗慢性乙型肝炎患者的疗效及对HBsAg水平的影响  

Efficacy of Different Kinds of Nucleoside Analogues in the Treatment of Patients with Chronic Hepatitis B and Their Influence on HBsAg Levels

作　　者：张娜 ZHANG Na(Department of Infectious Diseases,Tianjin Ninghe District Hospital,Tianjin 301500,China)

机构地区：[1]天津市宁河区医院感染科,天津301500

出　　处：《医学信息》2021年第9期96-98,共3页Journal of Medical Information

摘　　要：目的探讨不同种类核苷类似物治疗慢性乙型肝炎患者疗效及对HBsAg水平影响。方法选取2019年1月~2020年1月于我院就诊的120例慢性乙型肝炎患者,随机分为A、B、C三组,每组40例。在常规护肝、降酶、利胆等治疗基础上,A组患者接受阿德福韦酯治疗,B组患者接受替诺福韦治疗,C组患者接受恩替卡韦治疗,比较三组患者疗效(HBV-DNA转阴率、HBs-Ag水平)、肝功能(ALT、AST、TB、ALB)及不良反应发生率。结果B、C组患者HBV-DNA转阴率高于A组,差异有统计学意义(P<0.05),三组患者HBs-Ag水平均较治疗前降低,且B、C组HBs-Ag水平低于A组,差异均有统计学意义(P<0.05);治疗12个月后,三组患者ALT、AST、TB水平低于治疗前,ALB水平高于治疗前,且B、C组患者ALT、AST、TB水平低于A组,ALB水平高于A组,差异均有统计学意义(P<0.05);三组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论恩替卡韦及替诺福韦治疗慢性乙型肝炎患者疗效更好,可有效改善患者肝功能,安全可靠。Objective To investigate the curative effect of different kinds of nucleoside analogs in the treatment of patients with chronic hepatitis B and their influence on HBsAg levels.Methods A total of 120 patients with chronic hepatitis B who were treated in our hospital from January 2019 to January 2020 were selected and randomly divided into three groups:A,B,and C,with 40 cases in each group.On the basis of conventional treatments such as liver protection,enzyme lowering,and choleretic treatment,patients in group A received adefovir dipivoxil treatment,patients in group B received tenofovir treatment,and patients in group C received entecavir treatment.The curative effect(HBV-DNA conversion rate,HBs-Ag level),liver function(ALT,AST,TB,ALB)and the incidence of adverse reactions were compared among the three groups of patients.Results The HBV-DNA conversion rate of patients in groups B and C was higher than that in group A,the difference was statistically significant(P<0.05).The HBs-Ag levels of the three groups of patients were lower than before treatment,and the HBs-Ag levels of groups B and C were lower than those of group A,the differences were statistically significant(P<0.05);After 12 months of treatment,the ALT,AST,and TB levels of the three groups were lower than before treatment,and the ALB level was higher than before treatment,and the ALT,AST and TB levels of patients in groups B and C were lower than those in group A,and the ALB level was higher than that in group A,the differences were statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions among the three groups of patients(P>0.05).Conclusion Entecavir and tenofovir have better curative effect in the treatment of patients with chronic hepatitis B.They can effectively improve the liver function of patients and are safe and reliable.

关 键 词：核苷类似物 阿德福韦酯 替诺福韦 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]