恩替卡韦应答不佳慢性乙型肝炎患者换用艾米替诺福韦的临床疗效  

Clinical efficacy of switching to tenofovir amibufenamide tablets with poor response to entecavir in patients with chronic hepatitis B

作　　者：李云 王文艳 Li Yun;Wang Wenyan(Department of Infectious Disease,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院感染科,临沂276400

出　　处：《中华肝脏病杂志》2024年第S1期6-9,共4页Chinese Journal of Hepatology

摘　　要：目的分析恩替卡韦应答不佳慢性乙型肝炎患者换用艾米替诺福韦片治疗的临床疗效。方法选取2021年7月至2024年7月临沂市中心医院收治的40例恩替卡韦应答不佳慢性乙型肝炎患者为研究对象,其中乙型肝炎e抗原(HBeAg)阴性18例、HBeAg阳性22例。均采用艾米替诺福韦片治疗。比较HBeAg阴性和HBeAg阳性患者治疗前、治疗12周、治疗24周丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)的差异,并比较HBeAg阴性和HBeAg阳性患者治疗12周、治疗24周乙型肝炎病毒(HBV)DNA转阴率。据资料不同采用t检验、单因素方差分析、LSD-t检验、χ^(2)检验进行统计学分析。结果治疗前,HBeAg阳性患者ALT、AST水平高于HBeAg阴性患者(P<0.05),治疗12周后、治疗24周后HBeAg阴性、HBeAg阳性患者ALT、AST水平均低于治疗前,且HBeAg阴性患者低于HBeAg阳性患者(P<0.05)。治疗12周后,HBeAg阳性患者HBV DNA转阴率低于HBeAg阴性患者(P<0.05),治疗24周后,HBeAg阳性和HBeAg阴性患者HBV DNA转阴率差异无统计学意义(P>0.05)。结论恩替卡韦应答不佳慢性乙型肝炎患者换用艾米替诺福韦片可改善肝功能,促进HBV DNA转阴,且对于HBeAg阴性患者的治疗效果更好。Objective To analyze the clinical efficacy of switching to tenofovir amibufenamide tablets with poor response to entecavir in patients with chronic hepatitis B.Method Forty patients with chronic hepatitis B who had poor responses to entecavir,admitted to Linyi Central Hospital from July 2021 to July 2024,were selected as the study subjects.Among them,18 and 22 cases were hepatitis B e antigen(HBeAg)negative and positive,respectively.All patients were treated using tenofovir amibufenamide tablets.The differences in alanine aminotransferase(ALT)and aspartate aminotransferase(AST)prior to treatment,at 12 and 24 weeks of treatment,were compared between HBeAg-negative and positive patients.The hepatitis B virus(HBV)DNA negative conversion rate was compared after 12 and 24 weeks of treatment between HBeAg-negative and positive patients.Statistical analysis was performed using t-test,one-way ANOVA,LSD-t test,andχ^(2)test according to different data.Result ALT and AST levels were higher in HBeAg-positive than those of HBeAg-negative patients(P<0.05)prior to treatment.ALT and AST levels were lower in HBeAg-negative and HBeAg-positive patients compared to pre-treatment,while those of HBeAg-negative patients were lower than those of HBeAg-positive patients(P<0.05)after 12 and 24 weeks of treatment.The HBV DNA negative conversion rate was lower in HBeAg-positive patients than that of HBeAg-negative patients(P<0.05)after 12 weeks of treatment.There was no statistically significant difference in the HBV DNA conversion rate between HBeAg-positive and HBeAg-negative patients after 24 weeks of treatment(P>0.05).Conclusion Switching to tenofovir amibufenamide tablets can improve liver function and promote HBV DNA negative conversion with poor response to entecavir in patients with chronic hepatitis B,with better therapeutic effect in HBeAg-negative patients.

关 键 词：慢性乙型肝炎 恩替卡韦 治疗 应答不佳 艾米替诺福韦 

分 类 号：R51[医药卫生—内科学]