恩替卡韦治疗高病毒载量慢性乙型肝炎疗效观察

Therapeutic effect of entecavir in treatment of chronic hepatitis B with high viral load

目的观察恩替卡韦治疗慢性乙型肝炎高病毒载量的临床疗效。方法随机选择未经过抗病毒治疗的慢性乙型肝炎患者59例,分为治疗组和对照组。治疗组:恩替卡韦0.5 mg每日1次,对照组:拉米夫定100 mg每日1次,观察2组患者治疗后12周、24周、48周的HBVDNA及ALT下降及转阴情况。结果治疗组在治疗12周、24周、48周HBVDNA下降值分别为3.70±0.68,2.64±0.58,2.20±0.56;对照组下降值分别为4.16±1.02,3.27±1.23,3.24±1.12;2组比较差异有统计学意义(P<0.05)。治疗组在治疗开始后12周、24周、48周HBVDNA转阴率分别为64.28%、82.14%、89.28%;对照组组分别为32.25%、58.06%、64.50%,2组比较差异有统计学意义(P<0.05)。2组患者在治疗12周时ALT复常率比较差异无统计学意义(P>0.05),在24周、48周比较差异有统计学意义(P<0.05)。结论恩替卡韦治疗慢乙肝高病毒载量疗效显著,耐药发生率低。

Objective To analyze the antiviral effect of entecavir （ ETV） in treatment of chronic hepatitis B （ CHB） with high viral load （ HVL） .Methods 59 cases of patients with CHB were randomly chosen who had no previous history of antivi -ral therapy and were divided into a treatment group and a control group .The two groups were treated with ETV 0.5mg once daily or lamivudins （LAM） 100mg once daily.The results were closely observed after the treatment .Results 12,24 and 48 weeks after the treatment began , the drop-out values of HBVDNA for the treatment group were 3.70 ±0.68,2.64 ±0.58,and 2.20 ±0.56 respectively.However,the values for the control group were 4.16 ±1.02,3.27 ±1.23,3.24 ±1.12.There was statistical difference between the two groups （ P〈0.05）.HBVDNA negative conversion rates at the three time points were 64.28%,82.14%,89.28%for the treatment group and 32.25%,58.06%,64.50% for the control group respectively .The difference was significant（P〈0.05）.The recovery rate of ALT manifested significant difference between the two groups 24 and 48 weeks after the treatment began （P〈0.05）.Conclusion ETV has significant therapeutic effect in the treatment of chronic hepatitis B with high viral load with low rate of drug resistance .