拉米夫定与恩替卡韦治疗慢性乙型肝炎的抗病毒疗效和安全性

Antiviral efficacy and safety of lamivudine and entecavir in the treatment of chronic hepatitis B

目的分析拉米夫定与恩替卡韦治疗慢性乙型肝炎(CHB)的抗病毒疗效与安全性。方法 92例慢性乙型肝炎患者,采取信封随机分组方案分为常规组与实验组,每组46例。对常规组患者采取拉米夫定进行治疗,对实验组患者采取恩替卡韦进行治疗,对比两组的治疗效果及不良反应情况。结果随着疾病治疗时间的延长,乙型肝炎病毒脱氧核糖核酸(HBV DNA)阴转率逐渐增高,两组患者治疗后不同时间的HBV DNA阴转率比较差异均无统计学意义(P>0.05);两组治疗后不同时间的谷丙转氨酶(ALT)复常率比较差异均无统计学意义(P>0.05)。常规组患者治疗12、24、48周血清HBV DNA水平分别为(4.33±1.51)、(4.08±1.50)、(3.58±1.40)log10copies/ml,实验组患者在上述不同时间血清HBV DNA水平分别为(3.32±1.48)、(3.51±0.82)、(3.06±0.68)log10copies/ml,实验组患者治疗12、24、48周时血清HBV DNA水平明显低于常规组,差异均具有统计学意义(P<0.05)。两组患者用药后均未出现较为严重的药物不良反应现象。结论对慢性乙型肝炎患者采取恩替卡韦进行治疗可达到良好的抗病毒效果,药物安全性较高,值得实践推广。

Objective To analyze the antiviral efficacy and safety of lamivudine and entecavir in the treatment of chronic hepatitis B(CHB).Methods A total of92chronic hepatitis B patients were divided by envelope randomized grouping method into conventional group and experimental group,with46cases in each group.The conventional group was treated with lamivudine,and the experimental group was treated with entecavir.Comparison were made on treatment effect and adverse reaction condition in two groups.Results With the prolongation of disease treatment time,hepatitis B virus DNA(HBV DNA)negative rate gradually increased,and both groups had no statistically significant difference in HBV DNA negative rate at different times after treatment(P>0.05).Both groups had no statistically significant difference in recurrent rate of alanine aminotransferase(ALT)at different times after treatment(P>0.05).The conventional group had serum HBV DNA level after12,24and48weeks of treatment respectively as(4.33±1.51),(4.08±1.50)and(3.58±1.40)log10copies/ml,which were(3.32±1.48),(3.51±0.82)and(3.06±0.68)log10copies/ml in the experimental group.The experimental group had obviously lower serum HBV DNA level after12,24and48weeks of treatment than the conventional group,and their difference was statistically significant(P<0.05).No severe adverse reactions appeared after medication in two groups.Conclusion Entecavir shows excellent antiviral effect for chronic hepatitis B patients with high drug safety,and it is worthy of practice and promotion.