恩替卡韦治疗慢性乙型肝炎的临床疗效研究

Clinical Effect on Entecavir in Treatment of Chronic Hepatitis B

目的:探讨恩替卡韦治疗慢性乙型肝炎的效果,为临床慢性乙型肝炎抗病毒治疗提供依据。方法:选取在我院接受治疗的90例慢性乙型肝炎患者进行研究,采用随机数字表法将其随机分为对照组和实验组,每组45例。其中对照组患者给予阿德福韦酯联合拉米夫定常规治疗,实验组给予恩替卡韦治疗。分别在治疗第3个月、6个月、9个月和12个月时检测两组患者的组织学改善情况以及HBeAg转阴率、HBVDNA转阴率、ALT复常率等指标,同时记录两组患者治疗期间不良反应发生情况,以评价其治疗效果。结果:实验组患者治疗第6个月时HBVDNA转阴率明显高于对照组(P<0.05);两组患者HBeAg转阴率和ALT复常率在不同时间点比较均差异无统计学意义(P>0.05);治疗第12个月时,实验组患者HBVDNA下降值明显高于对照组(P<0.05),而两组患者HBeAg转换率比较差异无统计学意义(P>0.05);两组患者治疗第12个月时组织学改善率比较差异无统计学意义(P>0.05);两组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论:恩替卡韦治疗慢性乙型肝炎效果显著、起效快,长期应用效果与阿德福韦酯联合拉米夫定治疗效果相当,同时其不良反应少、安全性高,且在合并其他疾病患者的治疗中也能获得明显的效果。

Objective： To investigate the antiviral effect of entecavir in treatment of chronic hepatitis B, and to provide the basis for clinical treatment of chronic hepatitis B. Methods： 90 cases of chronic hepatitis B patients treated in our hospital were selected and randomly divided into the control group and the experimental group, 45 cases in each group. The control group were treated with adefovir and lamivudine treatment, the experimental group were treated with ente- cavir. The histological improvement rate, HBeAg negative conversion rate, HBVDNA negative conversion rate and ALT normalization rate of two groups were detected in 3 months, 6 months, 9 months and 12 months treatment. Results： The negative rate of HBVDNA of the experimental group when was significantly higher than the control group in 6 months treatment （P〈0. 05） ;two patients were HBeAg negative conversion rate and ALT normalization rate at different time points showed no obvious differences （P〉0. 05）;at 12 months, the decrease of HBVDNA of the experimental group was significantly higher than that of the control group （P〈0. 05）, while there was no significant difference in the HBeAg negative conversion rate between the two groups （P〉0. 05） ;there was no significant difference in histological improvement rate between the two groups in 12 months（P〉0. 05） ;there was no significant difference in the incidence of adverse reactions between the two groups （P〉0. 05）. Conclusion： Entecavir in treatment of chronic hepatitis B has significant effect and rapid onset. The therapy effect of a long-term application of entecavir treatment and adefovir com- bined with lamivudine is equivalent. At the same time,entecavir has high safety, less adverse reaction, and can obtain obvious effect in the treatment of patients with other diseases.