阿德福韦和恩替卡韦两种抗病毒药物的疗效比较

Comparision of the efficacy of two kinds of antiviral drugs Adefovir and Entecavir

目的比较阿德福韦和恩替卡韦两种抗病毒药物的疗效和安全性。方法将120慢性乙肝(CBV)患者分为两组,一组口服恩替卡韦,另一组口服阿德福韦,观察治疗4、12、24和48周时肝肾功能、HBV DNA水平及乙型肝炎病毒血清标志物的应答效果及血液分析的变化。结果对于HBeAg阳性患者,恩替卡韦组4、12、24和、48周HBV DNA转阴率较同期阿德福韦组的HBV DNA转阴率要高,统计分析显示有统计学意义(P<0.05),第4周恩替卡韦组HBV DNA转阴率(33%)要明显由于阿德福韦组(0)(P<0.01),而两组在ALT复常率、HBeAg转阴率方面统计分析显示差异无显著性(P>0.05);对于HBeAg阴性患者,在HBV DNA转阴率方面恩替卡韦组优于阿德福韦组(P<0.05),而两组患者的ALT复常率差异无统计学意义(P>0.05)。结论恩替卡韦治疗CBV在病毒学应答方面具有显著的抗病毒活性,尤其在早期明显由于阿德福韦。在生物化学应答及免疫学应答方面要高于阿德福韦,统计分析提示差异无显著性。

【Objective】To compare the efficacy and safety of antiviral drugs：Adefovir and Entecavir.【Method】 120 patients with chronic hepatitis B（CBV） were divided into two groups,one group was treated with Entecavir,another group was treated with Adefovir.Liver and kidney function,HBV DNA levels,hepatitis B virus serum markers of response effects and changes in blood analysis were observed after 4 weeks,12 weeks,24 weeks and 48 weeks respectively of the treatment.【Result】For the HBeAg-positive patients,the HBV DNA negative conversion rate in the Entecavir group was higher than that in the Adefovir group after 4 weeks,12 weeks,24 weeks,48 weeks of the treatment,and statistical analysis showed statistical significance（P 0.05）.In the 4th week,the HBV DNA negative conversion rate of the Entecavir group was（33%）,significantly higher than that of Adefovir group（0%）（P 0.01）.However,the ALT normalization rate and the HBeAg seroconversion rate between the two groups had no significant difference（P 0.05）;For HBeAg-negative patients,HBV DNA negative conversion rate of Entecavir group was superior to adefovir group（P 0.05）,while the ALT normalization rate between the two groups had no significant difference（P 0.05）.【Conclusion】Entecavir has significant anti-viral activity in the virological response in the treatment of CBV,which is particularly superior to Adefovir at the early stage.In the biochemical and immunological responses,entecavir is also higher than adefovir,but statistical analysis showed they have no significant difference.