4种抗病毒方案治疗慢性乙型肝炎的疗效分析

Efficacy analysis of four antiviral solutions for chronic hepatitis B treatment

目的观察4种抗病毒方案治疗慢性乙型肝炎(CHB)的疗效。方法将240例CHB患者按用药情况分为A、B、C、D组,分别给予口服拉米夫定、阿德福韦酯、阿德福韦酯/拉米夫定、恩替卡韦。比较各组治疗12、24、48周时的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)复常率,HBV DNA水平及转阴率,HBeAg/HBeAb转换率以及治疗48周时的YMDD变异率。结果 C组和D组的ALT、AST复常率,HBV DNA水平及转阴率,HBeAg/HBeAb转换率,以及YMDD变异率均优于A组和B组,差异均有统计学意义(P<0.05)。结论阿德福韦酯/拉米夫定和恩替卡韦是2种合理的治疗方案。

Objective To investigate the efficacy of four antiviral solutions for chronic hepatitis B（CHB）treatment.Methods240 cases of patients with CHB were selected,divided into four groups（group A,group B,group C and group D）,and treated with lamivudine,adefovir dipivoxil,adefovir dipivoxil/lamivudine,and entecavir,respectively.The recovery rates of ALT and AST,HBV DNA and its negative conversion rates,and HBeAg/HBeAb conversion rates of the four groups were compared respectively after12,24 and 48 weeks treatment.And the YMDD mutation rates were compared after 48 weeks treatment.Results The recovery rates of ALT and AST,HBV DNA and its negative conversion rates,HBeAg/HBeAb conversion rates,HBeAg/HBeAb conversion rates of group C and group D were significantly better than those of group A and group B（P〈0.05）.Conclusion The antiviral solutions of adefovir dipivoxil/lamivudine and entecavir are two kinds of rational treatment.