恩替卡韦治疗后慢性乙型肝炎低病毒血症患者序贯联合艾米替诺福韦治疗的价值  

Value of Sequential Combination with Emitinofovir Therapy in Patients with Chronic Hepatitis B Hypoviremia Following Entecavir Treatment

作　　者：吴开阳 胡正礼 秦桂来 WU Kaiyang;HU Zhengli;QIN Guilai(Department of Infection,Baoying County People's Hospital of Yangzhou,Yangzhou,Jiangsu,225800,China)

机构地区：[1]江苏省扬州市宝应县人民医院感染科,江苏扬州225800

出　　处：《中外医疗》2025年第1期53-56,共4页China & Foreign Medical Treatment

摘　　要：目的分析慢性乙型肝炎低病毒血症患者采用恩替卡韦治疗后序贯联合艾米替诺福韦治疗的临床效果。方法随机选取2021年12月-2023年12月江苏省扬州市宝应县人民医院收治的90例慢性乙型肝炎低病毒血症患者为研究对象,依据不同治疗方法分成对照组(45例)、观察组(45例)。对照组均接受恩替卡韦治疗,观察组在对照组基础上均接受序贯联合艾米替诺福韦治疗。对比两组患者治疗效果[乙肝病毒基因(hepatitis B virus gene,HBV-DNA)转阴率、乙型肝炎E抗原(hepatitis Be antigen,HBeAg)转阴率],肝功能指标[总胆红素(total bilirubin,TBIL)、天门冬氨酸转移酶(aspartate aminotransferase,AST)、白蛋白(serum albumin,ALB)、丙氨酸转移酶(alanine aminotransferase,ALT)]及不良反应发生率。结果观察组HBV-DNA转阴率为95.56%(43/45)、HBeAg转阴率为55.56%(25/45),均高于对照组的48.89%(22/45)、26.67%(12/45),差异均有统计学意义(χ^(2)=24.425,7.756;P均<0.05)。观察组TBIL、AST、ALT水平均低于对照组,ALB水平高于对照组,差异均有统计学意义(P均<0.05)。两组患者不良反应总发生率对比,差异无统计学意义(P>0.05)。结论慢性乙型肝炎低病毒血症患者采用恩替卡韦治疗后实施序贯联合艾米替诺福韦治疗,有助于提高HBV-DNA、HBeAg转阴率,改善肝功能,且安全性较高。Objective To investigate the effect of sequential combination of emtinofovir after treatment with entecavir in patients with chronic hepatitis B hypoviremia.Methods 90 patients with chronic hepatitis B hypoviremia treated in Baoying County People's Hospital of Yangzhou in Jiangsu Province from December 2021 to December 2023 were ran-domly selected as the study objects,and divided into control group(45 cases)and observation group(45 cases)accord-ing to different treatment methods.The control group received entecavir treatment,and the observation group received sequential combined therapy with emitinofovir based on the control group.The therapeutic effect[hepatitis B virus gene(HBV-DNA)negative conversion rate,hepatitis Be antigen(HBeAg)negative conversion rate],liver function indi-cators[total bilirubin(TBIL),aspartate aminotransferase(AST),serum albumin(ALB),alanine aminotransferase(ALT)]and the incidence of adverse reactions were compared between the two groups.Results The negative conver-sion rates of HBV-DNA 95.56%(43/45)and HBeAg 55.56%(25/45)in the observation group were higher than those of the control group 48.89%(22/45)and 26.67%(12/45),and the differences were statistically significant(χ^(2)=24.425,7.756;both P<0.05).The levels of TBIL,AST and ALT in the observation group were lower than those in the control group,and the levels of ALB were higher than that in the control group,the differences were statistically significant(all P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The sequential combination of entecavir and emitinofovir therapy in patients with chronic hepatitis B hypoviremia can improve the negative conversion rate of HBV-DNA and HBeAg and improve liver function,with high safety.

关 键 词：恩替卡韦 序贯联合艾米替诺福韦 慢性乙型肝炎低病毒血症 治疗效果 

分 类 号：R512.6[医药卫生—内科学]