替诺福韦酯与恩替卡韦抗病毒治疗慢性乙肝的效果对比

Comparison Effect of Tenofovir and Entecavir in the Treatment of Chronic Hepatitis B

目的:比较替诺福韦酯与恩替卡韦抗病毒治疗慢性乙肝(CHB)的临床效果。方法:选取2021年1月—2023年6月永州市第三人民医院收治的82例CHB患者开展前瞻性研究,以随机数表法将患者分为对照组与观察组,各41例。对照组口服恩替卡韦治疗,观察组口服替诺福韦酯治疗,两组均持续治疗6个月。比较两组临床疗效、肝功能指标、炎症指标、肝纤维化指标、生活质量、乙肝病毒(HBV)-DNA转阴率及不良反应。结果:观察组总有效率高于对照组,治疗后总胆红素(TBIL)、谷氨酰转肽酶(GGT)、天冬氨酸氨基转移酶(AST)及丙氨酸氨基转移酶(ALT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、白细胞介素-22(IL-22)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、层粘连蛋白(LN)水平低于对照组,生理、心理、社会、环境评分及HBV-DNA转阴率高于对照组,差异有统计学意义(P<0.05);但两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:替诺福韦酯治疗CHB效果优于恩替卡韦,可更好抑制HBV复制,加快HBV-DNA转阴,以减轻肝脏损伤,保护肝功能,安全可靠。

Objective:To compare the effect of Tenofovir and Entecavir in the treatment of chronic hepatitis B(CHB).Method:A prospective study was conducted on 82 patients with CHB who admitted to the Third People's Hospital of Yongzhou City from January 2021 to June 2023,the patients were divided into the control group and the observation group by random number table method,41 cases in each group.The control group was treated with Entecavir orally,and the observation group was treated with Tenofovir orally,two groups were treated for 6 months.The clinical efficacy,liver function indexes,inflammation indexes,liver fibrosis indexes,quality of life,HBV-DNA negative conversion rate and adverse reactions were compared between two groups.Result:The total effective rate of the observation group was higher than that of the control group,the levels of total bilirubin(TBIL),gamma-glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),alanine aminotransferase(ALT),tumor necrosis factor-α(TNF-α),interleukin-17(IL-17),interleukin-22(IL-22),typeⅣcollagen(Ⅳ-C),hyaluronic acid(HA)and laminin(LN)after treatment were lower than those of the control group,the physiological,psychological,social and environmental scores and HBV-DNA negative rate were higher than those of the control group,and the differences were statistically significant(P<0.05);but there was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:The effect of Tenofovir in the treatment of CHB is better than that of Entecavir,which can better inhibit HBV replication,accelerate HBV-DNA negative conversion,reduce liver damage,protect liver function,and is safe and reliable.