替诺福韦和恩替卡韦治疗初诊HBeAg阳性乙型肝炎的疗效比较  

Comparison of the efficacy of tenofovir and entecavir in the treatment of newly diagnosed HBeAg positive hepatitis B

作　　者：伍灵南[1] 龙云升[1] 黄志泳[1] 何龙芳[1] 梁宗柱 WU Ling-nan;LONG Yunsheng;HUANG Zhi-yong(The People’s Hospital of Xinyi,Maoming 525300,China)

机构地区：[1]信宜市人民医院感染科,广东茂名525300

出　　处：《中国处方药》2022年第8期110-112,共3页Journal of China Prescription Drug

摘　　要：目的探讨替诺福韦和恩替卡韦治疗初诊乙型肝炎E抗原(HBeAg)阳性乙型肝炎患者的疗效。方法选取2018年1月~2020年12月接受治疗并定期随诊的104例HBeAg阳性乙型肝炎患者,随机数字表法分为A组(替诺福韦抗病毒+常规治疗,52例)和B组(恩替卡韦抗病毒+常规治疗,52例)。治疗后不同时点,测定两组乙肝病毒脱氧核糖核酸(HBV-DNA)、HBeAg与丙氨酸氨基转移酶(ALT),统计指标转阴率,观察两组用药不良反应。结果A组治疗1、3、6个月时血清HBV-DNA转阴率高于B组,治疗3个月、6个月时HBeAg血清学转阴率高于B组,治疗1个月、3个月时ALT转阴率高于B组,差异有统计学意义(P<0.05)。治疗12个月时,两组HBV-DNA、HBeAg与ALT转阴率差异无统计学意义(P>0.05),用药不良反应率差异无统计学意义(P>0.05)。结论初诊HBeAg阳性的乙型肝炎患者以替诺福韦或恩替卡韦进行抗病毒治疗的效果及安全性相当,其中替诺福韦抗病毒作用的起效时间相对较早,有利于早期炎症控制及肝功能恢复。Objective To investigate the efficacy of tenofovir and entecavir in the treatment of newly diagnosed hepatitis B E antigen(HBeAg)positive hepatitis B patients.Methods A total of 104 patients with HBeAg positive hepatitis B who received treatment and regular follow-up in our hospital from January 2018 to December 2020 were selected and randomly divided into group A(tenofovir antiviral+conventional treatment,52 cases)and group B(entecavir antiviral+conventional treatment,52 cases).At different time points after treatment,the hepatitis B virus deoxyribonucleic acid(HBV-DNA),HBeAg,and alanine aminotransferase(ALT)were measured in the two groups,the negative rate of the indicators was counted,and the adverse drug reactions of the two groups were observed.Results The negative rate of serum HBV-DNA in group A was higher than that in group B at 1,3 and 6 months of treatment,and the negative rate of HBeAg seroconversion was higher than that in group B at 3 and 6 months of treatment.The negative rate of ALT at month was higher than that of group B,and the difference was statistically significant(P<0.05).At 12 months of treatment,there was no significant difference in the negative rate of HBV-DNA,HBeAg and ALT between the two groups(P>0.05),and there was no statistical difference in the adverse drug reaction rate(P>0.05).Conclusion The efficacy and safety of antiviral treatment with tenofovir or entecavir in newly diagnosed HBeAg-positive hepatitis B patients are comparable,and the antiviral effect of tenofovir has a relatively early onset time,which is conducive to early inflammation control and liver function recovery.

关 键 词：HBEAG阳性 乙型肝炎 替诺福韦 恩替卡韦 疗效 安全性 

分 类 号：R512.62[医药卫生—内科学]