恩替卡韦治疗慢性乙型肝炎的应用价值研究

Study on application value of entecavir in the treatment of chronic hepatitis B

目的观察探讨恩替卡韦在慢性乙型肝炎临床治疗中的应用效果。方法 110例慢性乙型肝炎患者,随机分为观察组和对照组,各55例。对照组给予阿德福韦酯治疗,观察组给予恩替卡韦治疗。比较两组患者治疗前后乙型肝炎病毒脱氧核糖核酸(HBV-DNA)、肝功能[谷丙转氨酶(ALT)、总胆红素(TBIL)]水平及ALT复常、HBV-DNA转阴情况。结果治疗前,两组患者HBV-DNA水平比较,差异无统计学意义(P>0.05);治疗3、6个月后,两组患者HBV-DNA水平均较本组治疗前降低,且观察组降低程度优于对照组,差异均具有统计学意义(P<0.05)。治疗前,两组患者ALT、TBIL水平比较,差异均无统计学意义(P>0.05);治疗6个月后,两组患者ALT、TBIL水平均较本组治疗前下降,且观察组降低程度优于对照组,差异均具有统计学意义(P<0.05)。观察组治疗3个月后的ALT复常率、HBV-DNA转阴率分别为30.9%、32.7%,治疗6个月后的ALT复常率、HBV-DNA转阴率分别为36.4%、40.0%,均高于对照组的14.5%、16.4%、18.2%、21.8%,差异均具有统计学意义(P<0.05)。结论在慢性乙型肝炎的临床治疗过程中,采用恩替卡韦抗病毒治疗可有效抑制乙型肝炎病毒的复制过程,患者服药依从性好且耐药率低,值得在临床上进行推广和应用。

Objective To observe and discuss the application effect of entecavir in clinical treatment of chronic hepatitis B. Methods A total of 110 chronic hepatitis B patients were randomly divided into observation group and control group, with 55 cases in each group. The control group was treated with adefovir dipivoxil, and the observation group was treated with entecavir. Comparison were made on levels of hepatitis B virus DNA（HBVDNA）, liver function [alanine aminotransferase（ALT）, total bilirubin（TBIL）], ALT normalization and HBVDNA negative-convention condition before and after treatment between two groups. Results Before treatment, both groups had no statistically significant difference in HBV-DNA level（P0.05）. After 3 and 6 months of treatment, both groups had lower HBV-DNA level than before treatment, and the observation group had better decline degree than the control group. Their difference was statistically significant（P0.05）. Before treatment, both groups no statistically significant difference in ALT and TBIL level（P0.05）. After 6 months of treatment, both groups had lower ALT and TBIL level than before treatment, and the observation group had better decline degree than the control group. Their difference was statistically significant（P0.05）. The observation group had ALT normalization and HBV-DNA negative-convention rate after 3 months of treatment respectively as 30.9% and 32.7%, and 36.4% and 40.0% after 6 months of treatment, which were all higher than 14.5%, 16.4%, 18.2% and 21.8% in the control group. Their difference was statistically significant（P0.05）. Conclusion During clinical treatment of chronic hepatitis B, entecavir antiviral therapy can effectively inhibit the replication of hepatitis B virus, with good compliance in patients and low drug resistance. It is worthy of clinical promotion and application.