恩替卡韦治疗33例慢性乙型肝炎疗效分析

Analysis of the curative efficacy in patients with chronic hepatitis B treated with entecavir

目的探讨恩替卡韦对33例乙型肝炎（乙肝）的治疗效果。方法应用恩替卡韦0．5mg／d口服治疗33例乙肝患者，其中慢性携带者7例，慢性轻度患者12例，慢性中度患者14例。主要检测血清HBVDNA水平，与基线值相比的平均下降量，HBVDNA阴转率（〈3log10拷贝／ml）；并同时检测ALT、AST复常率。结果三组患者HBVDNA水平随治疗时间延长呈进行性下降，与基线相比的平均下降量也相应逐渐增加，三组两两比较差异无统计学意义。治疗24周后，携带者HBVDNA阴转率为57．1％，轻度患者为75．0％，中度患者为100．0％。其中，中度患者在治疗至12周、24周、36周时，HBVDNA阴转率显著高于携带者（P〈0．05），仅在12周时HBVDNA阴转率高于轻度患者（P〈0．01）。中度患者48周时有5例达血清转换（35．7％），轻度患者在48周时有4例达血清转换（33．3％）。轻度、中度患者分别在36周、24周时ALT／AST完全复常。结论 恩替卡韦治疗乙肝有较高疗效，安全，耐药风险低，值得推广。

Objective To evaluate the curative efficacy in patients with chronic hepatitis B （CHB） treated with entecavir （ETV）. Method 33 patients with CHB （7 HBV-chronic carriers, 12 mild cases and 14 moderate cases） were treated with entecavir 0.5 mg/d and detected serum HBV DNA, ALT, AST level and HBeAg seroconversion.Results Serum HBV DNA levels of 3 groups were dropped gradually with the therapy. The average declining counts compared with the baseline were increased too. There were no significant differences in the 3 groups compared with each other. At week 24 after treatment, the rates of HBV DNA reduced to negative were 57.1%, 75.0% and 100.0% in HBV-chronic carriers group, mild group and moderate group respectively. The rates of HBV DNA reduced to negative in moderate group were higher than that of in HBV-chronic carriers group at 12, 24, 36 weeks（ P 〈0.05）.The rate of HBV DNA reduced to negative in mederate group was higher than that of in mild group at 12 weeks only（ P 〈 0.01）. 5 cases（35.7%） procured HBeAg serocofiversion at 48 weeks in moderate group. 4 cases（33.3% ） procured HBeAg 48 weeks in mild group. ALT/AST recovered to normal in mild group at 36 weeks, in moderate group at 24 weeks respectively. Conclusions ETV is efficacy and safety in patients with chronic hepatitis B.