替比夫定和拉米夫定对e抗原阳性慢性乙型肝炎的临床疗效

Clinical efficacy of telbivudine and lamivudine in HBeAg positive chronic hepatitis B patients

目的评价替比夫定对e抗原阳性慢性乙型肝炎患者的临床疗效。方法收集我院120例经拉米夫定或替比夫定治疗的乙型肝炎E抗原(HBeAg)阳性慢性乙型肝炎患者临床资料,对比拉米夫定和替比夫定患者在4,8,12,24,48周时HBV-DNA水平和HBeAg血清学转换率,且评价治疗期间2组患者不良反应。结果 2组患者在4,8,12周时HBV-DNA水平和HBeAg血清学转换率,组间差异无统计学意义(P>0.05)。与拉米夫定组比较,替比夫定组24,48周时HBV-DNA水平明显较低,HBeAg血清学转换率明显较高(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。替比夫定组40岁以下患者治疗48周时HBeAg血清学转换率为49%,40岁以上患者为9.5%,组间差异有统计学意义(P<0.05)。结论替比夫定治疗40岁以下的HBeAg阳性慢性乙型肝炎患者有较高的HBeAg血清学转换率,且不良反应轻微。

Objective To investigate the effect of telbivudine in HBeAg positive chronic hepatitis B patients. Methods The clinical data of 120 patients with HBeAg positive chronic hepatitis B treated with lamivudine and telbivudine in our hospital were collected. The HBV DNA level and HBeAg seroeonversion rate of lamivudine group and telbivudine group at the 4^th, 8^th, 12^th, 24^th and 48^th week were compared as well as differ- ences of adverse reactions during treatment. Results The result showed that there were no statistical differences between the groups at the 4^th , 8^th and 12^th week （ P 〉 0. 05 ）. Compared with the lamivudine group, the HBV - DNA level in telbivudine group was significantly lower while E antigen seroconversion rate was significantly higher at the 24^th and 48^th week, the difference between groups were statistically significant （P 〈 0.05 ）. The incidence of adverse reactions between the two groups had no statistical difference （ P 〉 0. 05 ）. In telbivudine group, the HBeAg seroconversion rate of patients under the age of 40 was 49% at the 48th week of treatment while it was 9.5% in patients over 40, the difference between two groups was statistically significant （P 〈 0. 05 ）. Conclusion Petients under the age of 40 with HBeAg positive chronic hepatitis B treated with telbivudine has a higher HBeAg seroeonversion rate and mild adverse reactions.