摘要
目的:观察和比较替比夫定、拉米夫定治疗慢性乙型肝炎的1年疗效和不良反应。方法:采用1∶1随机、对照设计。共入组慢性乙型肝炎患者240例,其中HBeAg阳性和阴性各120例,各组分为替比夫定组60例,拉米夫定组各60例。结果:治疗52周时,HBeAg阳性和阴性患者中,替比夫定组血清HBV DNA自基线下降水平、HBV DNA低于检测下限的比率、病毒反跳率和耐药率,均优于拉米夫定组,P<0.05。HBeAg阳性患者中替比夫定组HBeAg阴转率和治疗应答反应率高于拉米夫定组,差异有显著性意义,P<0.05;替比夫定组HBeAg血清转换高于拉米夫定组,差异无显著性意义,P>0.05。HBeAg阳性和阴性患者中,替比夫定与拉米夫定两组ALT复常率差异无显著性意义,P>0.05。替比夫定不良反应轻微,与拉米夫定类似。结论:替比夫定较拉米夫定具有更强的抑制HBV DNA复制能力以及较少的耐药率和病毒反跳率。
Objective： To investigate the efficacy and side effects of telbivudine and lamivudine for therapy of chronic hepatitis B for 1 year, Methods： In this random and control study, the efficacy of telbivudine and lamivudine treatments were compared in 240 patients who consisted of 120 cases with HBeAg-negative and 120 cases with HBeAg-positive chronic hepatitis B. The patients were randomly assigned to a daily 600mg telbivudine treatment group or daily 100mg tamivudine group for 52weeks. Results： At week 52, mean reductions of serum HBV DNA from baseline and undetectable serum HBV DNA rates among patients with HBeAg-negative and HBeAg-positive chronic hepatitis B were significantly greater in the telbivudine-treated patients than in the lamivudine-treated group （ P 〈 0. 05 ） . Viral resistance and viral breakthrough was significant common in lamivudine compared with telbivudine （ P 〈 0. 05 ） . Among patients with HBeAg-positive chronic hepatitis B, telbivudine was significant superior to lamivudine with respect to loss of HBeAg （ P 〈 0. 05 ） and seroconversion of HBeAg （ P 〉 0. 05 ） . Telbivudine was well-tolerated with an adverse event profile similar to that of lamivudine. There was no significant difference in ALT normalization at week 52 between patients treated with tebivudine and lamivudine. Conclusion： Telbivudine is significant superior to lamivudine with respect to strong suppression of HBV DNA replication and less resistance to the nueleosides as well as viral breakthrough.
出处
《中西医结合肝病杂志》
CAS
2009年第1期19-21,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
