艾米替诺福韦和恩替卡韦治疗慢性乙型肝炎早期临床疗效及安全性比较  

Comparison of Early Clinical Efficacy and Safety of Tenofovir Amibufenamide Versus Entecavir in the Treatment of Chronic Hepatitis B

作　　者：马海艳 郝鹏 潘丹 焦亚军 豆妮娜 MA Haiyan;HAO Peng;PAN Dan;JIAO Yajun;DOU Nina(Hebei Petrochina Central Hospital,Langfang,Hebei,China 065900)

机构地区：[1]河北中石油中心医院,河北廊坊065900

出　　处：《中国药业》2025年第7期105-108,共4页China Pharmaceuticals

基　　金：河北省廊坊市科技支撑计划项目[2023013233]。

摘　　要：目的比较艾米替诺福韦和恩替卡韦治疗慢性乙型肝炎(CHB)的早期疗效和安全性。方法选取医院门诊2021年11月至2023年5月收治的CHB患者142例,按治疗方案的不同分为恩替卡韦组(87例)和艾米替诺福韦组(55例),再按乙型肝炎E抗原(HBeAg)阴性、阳性分为HBeAg(-)和HBeAg(+)2个亚组。HBeAg(-)中,恩替卡韦组、艾米替诺福韦组分别有40例、19例;HBeAg(+)中,恩替卡韦组、艾米替诺福韦组分别有47例、36例。恩替卡韦组患者予恩替卡韦,艾米替诺福韦组患者予艾米替诺福韦,两组患者均连续治疗24周。结果治疗12周后,艾米替诺福韦组HBeAg(-)和HBeAg(+)患者的乙型肝炎病毒(HBV)DNA应答率均显著高于恩替卡韦组(89.47%比65.00%,41.67%比19.15%,P<0.05);治疗24周后,艾米替诺福韦组和恩替卡韦组HBeAg(-)和HBeAg(+)患者的HBV DNA应答率相当(89.47%比80.00%,58.33%比48.94%,P>0.05)。治疗后,艾米替诺福韦组和恩替卡韦组患者的HBeAg转阴率分别为2.78%(1/36)和8.51%(4/47)。治疗12周、24周后,艾米替诺福韦组和恩替卡韦组HBeAg(-)和HBeAg(+)患者的丙氨酸氨基转移酶复常率相当(P>0.05)。治疗12周后,艾米替诺福韦组HBeAg(-)患者的肌酐显著高于恩替卡韦组(P<0.05),但均在正常值范围内;治疗24周后,两组患者的肌酐相当(P>0.05)。治疗12周、24周后,艾米替诺福韦组和恩替卡韦组HBeAg(-)和HBeAg(+)患者的肝肾功能指标总胆红素、血尿素氮、尿酸均相当(P>0.05);艾米替诺福韦组和恩替卡韦组HBeAg(+)患者的血脂指标总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均相当(P>0.05)。艾米替诺福韦组和恩替卡韦组患者的不良反应发生率相当(12.73%比10.34%,P>0.05)。结论艾米替诺福韦的早期抗病毒能力更强,起效更快,其有效性和安全性与恩替卡韦相当。Objective To compare the early efficacy and safety of tenofovir amibufenamide versus entecavir in the treatment of chronic hepatitis B(CHB).Methods A total of 142 CHB patients admitted to the outpatient department of the hospital from November 2021 to May 2023 were selected and divided into the entecavir group(87 cases)and the tenofovir amibufenamide group(55 cases)according to different treatment plans.Based on whether they were negative or positive for hepatitis Be antigen(HBeAg),the patients in the two groups were further divided into the HBeAg(-)subgroups and the HBeAg(+)subgroups.In HBeAg(-)subgroups,there were 40 cases in the entecavir group and 19 cases in the tenofovir amibufenamide group,respectively.The patients in the entecavir group received entecavir,while patients in the tenofovir amibufenamide group received tenofovir amibufenamide.Both groups were treated continuously for 24 weeks.Results After 12 weeks of treatment,the response rates of hepatitis B virus(HBV)DNA in patients with HBeAg(-)and HBeAg(+)in the tenofovir amibufenamide group were significantly higher than those in the entecavir group(89.47%vs.65.00%,41.67%vs.19.15%,P<0.05).After 24 weeks of treatment,the HBV DNA response rates in patients with HBeAg(-)and HBeAg(+)were comparable between the tenofovir amibufenamide group and the entecavir group(89.47%vs.80.00%,58.33%vs.48.94%,P>0.05).After treatment,the HBeAg seroconversion rates in the tenofovir amibufenamide group and entecavir group were 2.78%(1/36)and 8.51%(4/47),respectively.After 12 and 24 weeks of treatment,the recovery rates of alanine aminotransferase were comparable in patients with HBeAg(-)and HBeAg(+)in the tenofovir amibufenamide group and entecavir group(P>0.05).After 12 weeks of treatment,the creatinine levels of patients with HBeAg(-)in the tenofovir amibufenamide group were significantly higher than those in the entecavir group(P<0.05),but both were within the normal range.After 24 weeks of treatment,the creatinine levels in the two groups were comparable(P>0.05).After 1

关 键 词：艾米替诺福韦 恩替卡韦 慢性乙型肝炎 有效性 安全性 

分 类 号：R969[医药卫生—药理学] R978.7[医药卫生—药学]