摘要
目的 比较恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的疗效.方法 使用英文检索词entecavir、adefovir、randomized controlled trial、chronichepatitis B;中文检索词恩替卡韦、阿德福韦酯、随机对照、慢性乙型肝炎,检索2013年12月1日以前Cochrane library、Pubmed、EMBASE、中国科技期刊数据库（维普）、中国期刊全文数据库（CNKI）、万方数字化期刊全文库中的恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的随机对照研究文献,用Review Manager 5.1软件通过Meta分析法比较二者的疗效.结果 共5项随机对照研究符合纳入标准.Meta分析结果显示,恩替卡韦在丙氨酸转氨酶（ALT）复常率[相对危险度（RR）=1.15,95％置信区间（CI）：1.03 ～ 1.29,P=0.01]、乙型肝炎病毒脱氧核糖核酸（HBV DNA）低于检测下限比例（RR=2.12,95％ CI：1.69 ～ 2.65）方面优于阿德福韦酯,差异有统计学意义（P＜0.01）;而2组乙型肝炎e抗原（HBeAg）转阴率（RR=1.01,95％ CI：0.67 ～ 1.52,P=0.98）、HBeAg血清转换率（RR=1.70,95％ CI：0.91～3.17,P=0.10）的差异无统计学意义.结论 恩替卡韦在促使患者ALT回复正常水平和降低血清HBV DNA载量方面优于阿德福韦酯,但在HBeAg转阴率、HBeAg血清转换率方面二者相似.
Objective To evaluate the effect of entecavir and adefovir in the treatment of patients with chronic hepatitis B.Methods Correspondent data were retrieved from database ochrane library,Pubmed,EMBASE,Chinese scientific journals database （VIP）,CNKI database,Wanfang database before December 1,2013 using the key words entecavir、adefovir、randomized controlled trial 、chronic hepatitis B to collect clinical randomized controlled trials.Statistical analysis was performed by Meta-analysis using Review Manager 5.1.Results Five randomized controlled trials met the inclusion and exclusion criteria.Meta-analysis showed that patients in entecavir group had higher rates of ALT normalization（RR =1.15,95% CI：1.03-1.29,P =0.01）,lowering HBV DNA to undetectable levels （RR =2.12,95% CI：1.69-2.65,P 〈 0.01）.The loss of HBeAg （RR =1.01,95 % CI：0.67-1.52,P =0.98） and HBeAg seroconversion （RR =1.70,95 % CI：0.91-3.17,P =0.10） had no statistical significanc.Conclusion Based on our Meta analysis results,the entecavir is superior to adefovir dipivoxil in decreasing serum HBV DNA and normalizing seruna ALT;however,as for the loss of HBeAg and HBeAg sero-conversion,the efficacies of the two drugs are similar.
出处
《中国医药》
2014年第12期1768-1772,共5页
China Medicine
基金
国家科技支撑计划（2013BA106804Y023118）
