泛昔洛韦和拉米夫定治疗慢性乙肝的短期疗效对比研究

Effects of short - term famciclovir or lamivudine in the treatment of patients with chronic hepatitis B

比较和评价泛昔洛韦和拉米夫定短期治疗慢性乙肝的疗效。将101例慢性乙肝患者,随机分为泛昔洛韦组(A组)1500mg/日分三次(4个月)、拉米夫定组(B组)100mg/日和对照组(C组)。结果显示,治疗4个月时①A、B和C组ALT的复常率分别为74.0%、82.5%和63.3%。②A和B组HBV DNA的阴转率为64.5%和90.0%均显著高于C组(16.5%),P<0.001;B组明显高于A组,P=0.017。③A和B组HBeAg血清转化率达27.3%和25.8%,高于C组(13.0%),但P>0.05。④A组HBV DNA阴转的20例患者,在停药后2、4和6月时其持续应答率分别为65.0%、45.0%和25.0%。表明泛昔洛韦和拉米夫定对慢性乙肝均有治疗效果,拉米夫定的抗病毒作用和疗效明显优于泛昔洛韦。

To evaluate and compare the effects of short - term famciclovir or lamivudine in the treatment of chronic hepatitis B. One hundred and one hospitalized patients with chronic： hepatitis B were enrolled and randomized into three groups. Group A （ n = 31 ）received famciclovir 500mg threes a day orally, group B （n = 40） received lamivudine 100mg once daily, group C （n = 30） was control patients. Results showed normalization rates of alanine transaminase in three groups were 74.0 %, 82.5 % and 63.3 %, respectively （P 〉 0.05）. Serum HBV DNA levels were reduced below the lower limit of quantification in group A （64.5%） and group B （90.0 % ）, respectively （ P = 0.017 ）. Much higher undetectable viral DNA rates achieved significantly in both groups than that in the control group （16.5%, P 〈 0. 001 ）. But HBeAg seroconversion rates had no difference statistically in these three groups （27.3 %, 25.8 % and 13.0%, P 〉 0.05）. The HBV DNA sustained virologic response rates in group A were 65.0 %, 45.0 % and 25.0% during follow- up of 2,4 and 6 months, respectively. Short - term famciclovir or lamivudine therapy are effective in the treatment of patients with chronic hepatitis B. Based on the clearance of serum HBV DNA, as an antiviral agent, the efficacy of lamivudine is superior to famciclovir.