恩替卡韦初治及阿德福韦酯耐药慢性乙型肝炎患者治疗96周的临床研究

Antiviral effects of entecavir in patients with nave hepatitis Band adefovir dipivoxil resistant for 96 weeks

目的观察恩替卡韦(ETV)治疗慢性乙型肝炎的临床疗效。方法 36例慢性乙型肝炎患者包括初治治疗组(20例)和阿德福韦酯(ADV)耐药组(16例),两组患者分别给予ETV 0.5 mg口服,1次/d,治疗96周。结果 ETV初治组和ADV耐药组患者治疗96周后,ALT复常率分别为100%和93.75%,差异无统计学意义(χ2=4.553,P>0.05);HBV DNA低于检测下限的比率均为100%;HBe Ag阴转率分别为42.8%和40.0%,差异无统计学意义(χ2=0.422,P>0.05);HBe Ag血清学转换率分别为21.4%和20.0%,差异无统计学意义(χ2=0.059,P>0.05)。两组患者耐受性均良好,无明显不良反应。结论 ETV治疗慢性乙型肝炎,对初治及阿德福韦耐药患者均能有效地控制病毒复制,改善肝功能,促使HBe Ag血清学转换,长期服药安全性好。

Objective To analyze the antiviral effects of enticavir in patients with hepatitis B. Methods Total of 36 patients with chronic hepatitis B including 20 na？ve patients and 16 patients with adefovir dipivoxil（ADV）-resistant, were treated with enticavir 0.5 mg daily. The efficacy was evaluated at 4th, 12 th, 24 th, 48 th and 96 th month, respectively. Results At 96 th month after treatment, the rates of ALT becoming normal were 100% and 93.75% in na？ve and in ADV-resistant patients, respectively, with no significant difference（χ^2 = 4.553, P 〉0.05）. The negative rats of HBV DNA of the two groups were all 100%. Negative rates of HBe Ag of the two groups were 42.8% and 40.0%, with no significant difference（χ^2 = 0.422, P〉 0.05）. The HBe Ag seroconversion rate of the two groups were 21.4% and 20.0%, respectively, with no significant difference（χ^2 = 0.059,P 〉0.05）. The two groups were all well tolerated and had no obvious adverse reactions. Conclusions Entecavir could effectively inhibit the replication of HBV, normalize of ALT and enhance conversion from anti-HBe to HBe Ag for cases with na？ve patients and patients with ADVresistant. It is safey for long-term medication.