替比夫定与恩替卡韦在HBeAg阳性慢性乙肝患者中的疗效对比

Efficacy of telbivudine versus that of entecavir for HBeAg-positive chronic hepatitis B

目的:比较替比夫定与恩替卡韦分别治疗HBeAg阳性慢性乙型肝炎患者的疗效。方法:将81例HBeAg阳性的慢性乙型肝炎患者随机分为替比夫定治疗组42例,恩替卡韦组治疗组39例,疗程均为60周。观察两组治疗8、12、24、48、60周时ALT复常率、HBVDNA转阴率、HBeAg血清学转换率。结果:两组的8、12、24、48、60周时ALT复常率、HBVDNA转阴率的差异均无统计学意义(均P>0.05);两组的8、12、24周时HBeAg血清学转换率的差异均无统计学意义(均P>0.05);治疗48周及60周时替比夫定组和恩替卡韦组HBeAg血清学转换率分别为31.0%、15.4%(P<0.05)和35.7%、25.1%(P<0.05)。结论:替比夫定与恩替卡韦对HBeAg阳性慢性乙型肝炎的治疗均有较好的效果,在中期的HBeAg血清学转换率上,替比夫定优于恩替卡韦。

Objective： To evaluate the efficacy of telbivudine versus those of entecavir for patients with HBeAg-positive chronic hepatitis B. Methods： 81 patients were randomized to receive telbivudine （42 patients） or entecavir （39 patients） for 60 weeks. Serum ALT normalization rate, rate of undetectable HBVDNA, HBeAg seroconversion rate were determined at weeks 8, 12, 24,, 48, and 60. Results： Serum ALT normalization rate and rate of undetectable HBV DNA did not differ significantly between the two groups at weeks 8, 12, 24, 48, and 60 （P〉0.05）, nor HBeAg seroconversion rate at weeks 8, 12, and 24 （P〉0.05）. HBeAg seroconversion rates was 31.0% in telbivudine group and 15.4% in entecavir group at week 48 （P〈0.05）, and 35.7% and 25.1% at week 60 （P〈0.05）. Conclusion： Both telbivudine and entecavir have good effect on HBeAg-positive chronic hepatitis B. Telbivudine has higher rate of HBeAg scroconvcrsion than entccavir at weeks 48 and 60.