恩替卡韦、拉米夫定治疗慢性乙型肝炎临床疗效比较

Effect comparison of entecavir and lamivudine in the treatment of chronic hepatitis B

目的比较分析恩替卡韦(ETV)、拉米夫定(LVD)治疗慢性乙型肝炎(CHB)的临床疗效。方法86例CHB患者根据丙氨酸氨基转移酶(ALT)水平随机分为ETV组、LVD组,各43例,分别予ETV 0.5 mg/d和LVD 100 mg/d口服,疗程均为72周。观察两组HBV-DNA阴转率、ALT复常率、HBeAg和HBeAb血清转化率以及不良反应发生情况。结果治疗24周后,ETV组、LVD组HBV-DNA转阴率分别为53.49%、48.84%,ALT复常率分别为88.37%、83.72%,差异无统计学意义(P>0.05)。治疗48周后,ETV组、LVD组HBV-DNA阴转率分别为88.37%、65.12%,ALT复常率分别为95.35%、86.05%,差异均有显著性(P<0.05)。治疗72周后,ETV组、LVD组HBV-DNA阴转率分别为97.67%、74.42%,ALT复常率分别为97.67%、81.40%,差异均有统计学意义(P<0.01)。ETV组HBeAg和HBeAb血清转化率较LVD组明显升高。两组患者均未见严重不良反应。结论恩替卡韦治疗慢性乙肝患者,较拉米夫定作用强,安全性好。

Objective To compare the effectiveness of entecavir（ETV） and lamivudine（LVD） in dealing with chronic hepatitis B（CHB）.Methods Eighty-six patients with CHB were randomly assigned to two groups,with 43 in each group.One group was administrated with ETV 0.5 mg/d,while the other was given LVD 100 mg/d.both of the course was 72 weeks.HBV-DNA negative conversion rate,ALT normalization rate,HBeAg and HBeAb seroconversion rates,and incidence of adverse reactions were observed.Results After 24 weeks of treatment,HBV-DNA negative conversion rates of the ETV and LVD groups were 53.49% and 48.84%（P0.05）,ALT normalization rates were 88.37% and 83.72%（P0.05）,respectively.After 48 weeks of treatment,HBV-DNA negative conversion rates of the ETV and LVD groups were 88.37% and 65.12%（P0.05）,ALT normalization rates were 95.35% and 86.05%（P0.05）,respectively.After 72 weeks of treatment,HBV-DNA negative conversion rates of the ETV and LVD groups were 97.67% and 74.42%（P0.01）,ALT normalization rates were 97.67% and 81.40%（P0.01）.The seroconversion rates of HBeAg and HBeAb in ETV group were significantly higher than LVD group.No serious side-effects were observed in both of the groups.Conclusion Compared with lamivudine,entecavir shows more stronger efficacy,and safety on treatment of chronic patients with hepatitis B.