替诺福韦酯与阿德福韦治疗慢性乙型肝炎患者的临床疗效及安全性比较  

Comparison of Clinical Efficacy and Safety of Tenofovir Dipivoxil and Adefovir in the Treatment of Patients with Chronic Hepatitis B

作　　者：周洪波 刘丹阳[1] 吕丹[1] 袁立红 刘琼[1] ZHOU Hong-Bo;LIU Dan-Yang;Lü Dan;YUAN Li-Hong;LIU Qiong(First Department of Internal Medicine,Sixth People's Hospital of Shenyang City,Shenyang 110057,China)

机构地区：[1]沈阳市第六人民医院内一科,沈阳110057

出　　处：《中国药物经济学》2021年第9期88-91,98,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨替诺福韦酯与阿德福韦治疗慢性乙型肝炎(CHB)患者的临床疗效及安全性。方法选取2015年1月至2019年4月在沈阳市第六人民医院接受诊治的慢性乙型病毒性肝炎患者130例作为研究对象,随机分为对照组与观察组,各65例。对照组给予阿德福韦,观察组给予替诺福韦酯,比较两组患者肝功能指标(丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBiL))变化情况,乙型肝炎e抗原(HBeAg)转阴率和ALT复常率,乙肝病毒脱氧核糖核酸(HBV-DNA)变化,治疗有效率以及不良反应发生情况。结果治疗后,两组ALT、AST以及TBiL水平较治疗前下降,且观察组ALT、AST以及TBiL水平低于对照组,差异有统计学意义(P<0.05)。治疗12周观察组HBe Ag转阴率高于对照组,但差异无统计学意义(P>0.05);治疗24周、48周,观察组HBe Ag转阴率明显高于对照组,差异有统计学意义(P<0.05)。在ALT复常率方面,观察组治疗12周、24周、48周的ALT复常率显著高于对照组,差异有统计学意义(P<0.05)。治疗12周观察组HBV-DNA不可测率高于对照组,但差异无统计学意义(P>0.05);治疗24周、48周观察组HBV-DNA不可测率高于对照组,差异有统计学意义(P<0.05)。观察组治疗有效率为96.92%,明显高于对照组的86.15%,差异有统计学意义(P<0.05)。对照组不良反应发生率为12.31%,观察组不良反应发生率为4.62%,差异无统计学意义(P>0.05)。结论与阿德福韦酯比较,替诺福韦酯对于治疗CHB患者可以取得更加理想的临床疗效,可有效降低肝功能相关指标,显著阻止HBV-DNA继续复制,尽快使CHB患者的肝功能恢复正常,是有效安全的治疗选择。Objective To discuss the clinical efficacy and safety comparison of tenofovir dipivoxil and adefovir in the treatment of chronic hepatitis B patients. Methods All the cases in this study were patients with chronic hepatitis B who were diagnosed and treated in Sixth People’s Hospital of Shenyang City from January 2015 to April 2018. A total of 130 cases were randomly divided into a reference group(n=65) and a study group(n=65). The reference group was given adefovir drug intervention, the study group was given tenofovir dipivoxil drug intervention, the two groups of patients were treated continuously for 1 year, and the liver function indexes of the two groups were compared(glutamate transferase (ALT), aspartate transferase (AST), Total bilirubin(TBiL)), hepatitis B E antigen(HBeAg) conversion rate and glutamate transferase(ALT) reversion rate, hepatitis B virus deoxyribonucleic acid quantitative(HBV-DNA) undetectable rate,total effective rate of treatment And the occurrence of adverse reactions. Results After 1 year of drug intervention in the 2 groups of CHB patients, the levels of liver function-related indicators ALT, AST, and TBIL decreased compared with those before treatment. The difference was statistically significant(P<0.05). The liver function index decreased more significantly than the reference group, and the difference was statistically significant(P<0.05). There was no significant difference in the conversion rate of HBeAg between the study group and the reference group at the 12 th week of treatment(P>0.05). At the 24 th and 48 th week after treatment, the rate of HBeAg conversion in the study group was significantly higher than that of the reference group. It is statistically significant(P<0.05). The ALT return rate of the study group was significantly higher than that of the reference group at the 12 th, 24 th, and 48 th weeks after treatment, and the difference was statistically significant(P<0.05). Compared with the reference group, the undetectable rate of HBV-DNA in the study group at the 1

关 键 词：慢性乙型肝炎 替诺福韦酯 阿德福韦酯 乙肝病毒脱氧核糖核酸 

分 类 号：R512.6[医药卫生—内科学] R978.7[医药卫生—临床医学]