替比夫定与阿德福韦酯治疗慢性乙型肝炎的临床疗效比较

Comparing study on telbivudine and adefovir dipivoxil for the treatment of chronic Hepatitis B

目的比较替比夫定与阿德福韦酯治疗慢性乙型肝炎(CHB)48周的临床疗效和安全性。方法选取2008年1月～2008年12月门诊44例CHB患者,应用替比夫定治疗,600 mg,1次/d,口服。同期30例CHB患者应用阿德福韦酯治疗,10 mg,1次/d,口服。均服用48周。观察48周血清丙氨酸转氨酶复常率、乙型肝炎病毒(HBV-DNA)阴转率、HBeAg阴转率和HBeAg血清转换率。并分别观察两组在12周、24周、36周的HBV-DNA阴转率、HBeAg阴转率。结果48周替比夫定ALT复常率95.5%(42/44),HBV-DNA阴转率54.5%(24/44),HBeAg阴转率为27.3%(12/44),HBeAg血清转换率11.4%(5/44),阿德福韦酯分别为93.3%(28/30)、26.7%(8/30)、3.3%(1/30),未发生HBeAg血清学转换。替比夫定HBV-DNA在24周阴转率为47.7%(21/44),HBeAg在24周阴转率为25%(11/44),阿德福韦酯在24周HBV-DNA阴转率为13.3%(4/30),24周未发生HBeAg阴转。结论替比夫定较阿德福韦酯有更快速、强效抗病毒作用,具有较高HBeAg阴转率和HBeAg血清转换率。

Objective To compare the clinical efficacy and safety of telbivudine and adefovir dipivoxil on chronic hepatitis B for 48 weeks.Methods Forty-four patients were treated with telbivudine（600 mg qd） and thirty patients were treated with adefovir dipivoxil（10 mg qd） for 48 weeks.After 48 weeks treatment,the normalization rate of ALT levels,the negative conversion rate of HBV-DNA,the negative conversion rates of HBeAg and the seroconversion rate of HBeAg were observed.The negative conversion rates of HBV-DNA and HBeAg were observed respectively in two groups at 12,24,36 weeks.Results After 48 weeks treatment,the normalization rate of ALT levels,the negative conversion rates of HBV-DNA and HBeAg,the seroconversion rate of HBeAg were 95.5%（42/44）,54.5%（24/44）,27.3%（12/44）,and 11.4%（5/44） respectively in telbivudine group.The normalization rate of ALT levels,the negative conversion rates of HBV-DNA and HBeAg were 93.3%（28/30）,26.7%（8/30）,3.3%（1/30） respectively and no seroconversion of HBeAg occurred in adefovir dipivoxil group.At 24 weeks of treatment,the negative conversion rates of HBV-DNA and HBeAg were 47.7%（21/44） and 25%（11/44） respectively in telbivudine group.The negative conversion rate of HBV-DNA was 13.3%（4/30）,no negative conversion of HBeAg occurred in adefovir dipivoxil group.Conclusion Telbivudine could effectively inhibit the replication of HBV-DNA than Adefovir dipivoxil.The negative conversion rate of HBeAg and the seroconversion rate of HBeAg are higher in telbivudine group.