替比夫定治疗慢性乙型肝炎37例近期疗效观察

Short-term clinical effect of telbivudine in the treatment chronic hepatitis B

目的研究替比夫定(LdT)对慢性乙型肝炎治疗近期疗效和安全性。方法慢性乙型肝炎患者口服替比夫定。患者包括初次使用替比夫定患者21例和阿德福韦酯原发治疗失败后换用替比夫定患者16例两组。治疗前后测定基线HBVDNA水平、HBVM、肝肾功能、肌酸肌酶。结果两组患者治疗1月、3月、6月后ALT较治疗前明显下降(P<0.05),两组之间治疗前后ALT比较没有显著性差异(P>0.05)。两组患者治疗1月log值下降幅度无明显差异(P>0.05),治疗3月、6月后log值下降幅度差异有统计学意义(P<0.05)。初次用药与更换用药在HBVDNA转阴和HBeAg血清转换方面在治疗6月内差异无统计意义(P>0.05)。结论替比夫定治疗慢性乙型肝炎,可迅速减少肝损伤和降低HBVDNA病毒载量,3、6月时初次用药降低病毒载量优于阿德福韦酯原发治疗失败后更换用药者。

Objective To study the efficacy and safety of telbivudine in the treatment of chronic hepatitis B （CHB）.Methods A total 37 patients with CHB were divided in to two groups.Group one （n=21） patients were treated with telbivudine from the beginning and group two （n=16） patients were treated with telbivudine after treatment failure with adefovir dipivoxil.Each patient received 600mg daily for 24 weeks.Serum ALT,HBV DNA and creatine kinase levels were measured before and after treatment.Results After treatment,the level of serum ALT decreased dramatically in both groups （p〈0.05） but the decrease was not statistically significant between the two groups.After one month of treatment the mean reduction of HBV DNA from baseline didn＇t show significant difference between the two groups,but it reduced significantly after 3 to 6 months of treatment （p〈0.05）.There was no significant difference in HBV DNA level and HBeAg seroconversion between the two groups at the end of treatment.Conclusion Telbivudine seems to be effective and safe in viral load reduction if it is taken at the beginning of treatment.