恩替卡韦与替比夫定治疗成人慢性乙型肝炎的疗效比较

Study on the efficacy between entecavir and telbivudine in treating chronic hepatitis B patients

目的:了解恩替卡韦治疗成人慢性乙型肝炎的疗效。方法:115例患者随机分为替比夫定组(52例)和恩替卡韦组(63例),分别予替比夫定和恩替卡韦治疗,并在治疗前,治疗后12,24,36,48周检测患者血清ALT(谷丙转氨酶)水平、HBeAg(乙型肝炎e抗原)滴度和HBV DNA(乙型肝炎病毒核酸)拷贝数。结果:治疗后,2组患者ALT水平、HBeAg滴度和HBV DNA拷贝数与治疗前比较下降有统计学意义(P<0.05)。2组患者之间比较,ALT水平、HBeAg滴度下降及转阴率、转换率、HB-VDNA阴转率比较,差异无显著性(P>0.05)。2组患者HBV DNA拷贝数下降幅度比较,恩替卡韦组优于替比夫定组(P<0.05)。结论:恩替卡韦和替比夫定均有抑制乙肝病毒的作用,恩替卡韦对HBV复制的抑制能力优于替比夫定。

OBJECTIVE To study the efficacy and safety of entecavin （ETV） in the treatment of chronic hepatitis B patients. METHODS 63 cases of HBeAg positive chronic hepatitis B patients were selected randomly as treatment group, treated with ETV. Another 52 cases of HBeAg positive chronic hepatitis patients were selected as observation group , treated with tel- bivudinefTBD）. Patients liver function, HBV DNA level, hepatitis B serology marker were assessed at 0 week, 12th week, 24th week, 36th week and 48th week. RESULTS The mean decline of patients liver function, HBV DNA level and hepatitis B serology marker from baseline were significantly in both groups（P〈0. 05）. There was no significant difference between the two groups in HBeAg seroconversion and the decline grade of patients＇ liver functions. ETV was superior in decline grade of HBV DNA level（P〈0. 05）. CONCLUSION Both ETV and TBD are effective and safe for the treatment of chronic hepatitis B patients, but ETV is superior in inhibition of HBV replication.