恩替卡韦对慢性乙型肝炎、肝硬化代偿期和失代偿期的2年抗病毒疗效比较

Two-year Efficacy of Entecavir for the Treatment of Chronic Hepatitis B,Compensated and Decompensated Cirrhosis

目的慢性乙型肝炎、乙肝肝硬化代偿期和失代偿期不同阶段患者对恩替卡韦抗病毒疗效的影响尚不明确。本文观察以上患者应用恩替卡韦的2年抗病毒疗效。方法对初治的慢性乙型肝炎(41例)、乙肝肝硬化代偿期(15例)和失代偿期(7例)患者应用恩替卡韦治疗2年,每3个月检测谷丙转氨酶等生物化学及HBV DNA等病毒学指标观察临床疗效。结果3组患者在治疗前基线各项指标差异无统计学意义,具有可比性。恩替卡韦治疗1年和2年ALT的复常率和HBeAg血清转换率3组相似。每3个月检测的HBV DNA低于最低检测限(<5×105IU/mL)比例和下降的中位数3组相似,2年时分别为慢性乙型肝炎(81.8%,5.4 lg IU/mL)、乙肝肝硬化代偿期(83.3%,6.0 lg IU/mL)和失代偿期(88.1%,5.8 lg IU/mL)。3组患者的HBVDNA血清浓度在各时间点的动力学变化差异无统计学意义。结论对慢性乙型肝炎、肝硬化代偿期和失代偿期3组患者用恩替卡韦治疗2年,抗病毒疗效和HBV DNA动态变化差异无统计学意义。

Objective To compare antiviral effects of entecavir in patients with chronic hepatitis B,compensated and decompensated cirrhosis patients after 2 years of treatment with entecavir.Methods Totally 63 treatment-nave patients with chronic hepatitis B（41 cases）,compensated（15 cases） and decompensated cirrhosis（7 cases） patients were treated with entecavir 0.5 mg once daily.Alanine aminotransferase（ALT） and HBV DNA were detected and analyzed at three-month interval.Results The baseline characteristics of the three groups were comparable by age,gender,ALT and HBV DNA.There was no significant difference in ALT normalization and HBeAg seroconversion rate after one-year and two-year entecavir treatment.The 2-year HBV DNA undetectable（5×105 IU/mL） rate and median reductions were 81.8% and 5.4 lg in chronic hepatitis B,83.3% and 6.0 lg in compensated cirrhosis,88.1% and 5.8 lg in decompensated cirrhosis.The kinetics of HBV DNA suppression at every 3 months interval were similar among three groups.Conclusion There was no significant difference efficacy of after 2 years of treatment with entecavir in patients with chronic hepatitis B,compensated and decompensated cirrhosis patients.