替比夫定治疗慢性乙型肝炎的临床疗效评价

Clinical Efficacy for Telbivudine Treatment of Chronic Hepatitis B

目的探讨替比夫定治疗慢性乙型肝炎的临床疗效。方法选取50例慢性乙型肝炎患者,分成治疗组及对照组,治疗组给予替比夫定600mg/d口服,对照组给予拉米夫定100mg/d口服,二者使用剂量均为临床常规用量;测量治疗4周、12周、24周时患者血清中HBV-DNA的拷贝量下降值,PCR检测不到的比例(检测不到指的是拷贝量<300copies/mL),还有包括ALT复常率和HBeAg转阴情况。结果替比夫定有较强的抗病毒作用,本次临床对照试验发现,治疗组替比夫定降低HBV-DNA拷贝量的临床效果明显优于拉米夫定降低HBV-DNA拷贝量的效果,二者间差异有显著性(P<0.05);治疗组替比夫定治疗使得HBV-DNA转阴病例数与对照组拉米夫定治疗转阴病例数间有显著性差异(P<0.05),治疗组转阴率明显高于对照组;治疗组替比夫定治疗使得ALT复常的病例数与对照组拉米夫定治疗复常病例数间无显著性差异(P>0.05),尚不能认为治疗组与对照组治疗对于ALT复常有显著性差异;治疗组与对照组治疗对于HBeAg转阴在统计学上存在显著性差异(P<0.05)。结论慢性乙型肝炎治疗目标是最大限度地长期抑制或清除掉HBV病毒,减轻肝细胞炎症坏死和纤维化,延缓和阻止疾病的进展恶化,替比夫定在病毒学、组织学改善等方面具有明显的优势。

Objective To investigate the telbivudine treatment of chronic hepatitis B treatment. Methods 50 cases of chronic hepatitis B patients, divided into treatment group and control group, treatment group received telbivudine 600mg/d orally, the control group received lamivudine 100mg/d orally, two doses are coutine clinical use consumption; measurement for 4 weeks, 12 weeks, 24 weeks in patients with serum HBV-DNA decline in the value of the copy, PCR detected ratio （not referring to the copy of the test is less than 300copies/ml）, also including ALT normalization and HBeAg negative situation. Results Telbivudine has strong antiviral activity, this controlled clinical trial found that telbivudine treatment group reduced the amount of HBV-DNA copies better than lamivudine in reducing clinical HBV-DNA copy of the volume of effect, the difference between the two was significant （P〈 0.05）; treatment group telbivudine treatment makes the number of cases of HBV-DNA negative with the negative control group, the number of cases between lamivudine significantly different （P 〈 0.05）, the treatment group was significantly higher negative; treatment group telbivudine treatment ALT normalization makes the number of cases treated with the control group, normalization of the number of cases lamivudine was no significant difference （P 〉 0.05）, still can not believe that the treatment group and control group for serum ALT are often significantly different; treatment group and control group in the treatment of HBeAg- negative statistically significant difference （P〈0.05）. Conclusion Chronic hepatitis B treatment goal is to maximize long-term HBV viral suppression or removed to reduce inflammation and necrosis of liver cells and fibrosis, delaying disease progression and prevent deterioration of telbivudine in virologic,histologic improvement has obvious advantage.