恩替卡韦与替诺福韦治疗慢性乙型肝炎的疗效及对肾功能的影响

Efficacy of entecavir and tenofovir in the treatment of chronic hepatitis B and its effect on renal function

目的分析和比较恩替卡韦与替诺福韦治疗慢性乙型肝炎的疗效及对肾功能的影响。方法从2016年9月～2017年10月期间诊治的慢性乙肝患者中随机抽取120例,采用随机数字表法随机分为对照组60例:实施恩替卡韦口服治疗,观察组60例进行替诺福韦口服治疗。比较两组患者的治疗效果以及对肾功能的影响。结果经过治疗后的12周、24周、36周、48周,两组患者的HBV DNA水平均低于治疗前,且观察组的HBV DNA水平均低于对照组,差异均有统计学意义(P <0.05)。治疗48周后,观察组的HBV DNA转阴率、ALT复常率、HBeAg转阴率均显著高于对照组,差异均有统计学意义(P <0.05)。治疗后36周、48周,观察组患者的肾小球滤过率较治疗前显著降低,两组比较差异均有统计学意义(P<0.05)。结论与恩替卡韦相比,替诺福韦的抗病毒能力更强,提高HBV DNA转阴性率、ALT复常率和HBeAg转阴率,但产生的肾毒性也更强,医师要结合患者的实际情况,合理选择药物治疗。

Objective To analyzed efficacy of entecavir and tenofovir in the treatment of chronic hepatitis B and its effect on renal function.Methods From the patients with chronic hepatitis B who were treated in our hospital from September 2016 to October 2017,120 patients were randomly selected and randomly divided into the control group by 60 patients in the control group:oral therapy with entecavir,and 60 patients in the observation group.Fuwei oral treatment.The treatment effects of the two groups of patients and the effects on renal function were compared.Results At 12 weeks,24 weeks,36 weeks,and 48 weeks after treatment,the HBV DNA levels in the two groups were lower than before treatment,and the HBV DNA levels in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After 48 weeks of treatment,the HBV DNA negative rate,ALT recurrence rate and HBeAg negative rate of the observation group were significantly higher than the control group,and the difference was statistically significant(P<0.05).At 36 weeks and 48 weeks after treatment,the glomerular filtration rate of the observation group was significantly lower than that before treatment,and the difference was statistically significant(P<0.05).Conclusion Compared with entecavir,tenofovir has stronger antiviral ability,higher HBV DNA transfection rate,ALT recurrence rate and HBeAg negative rate,but the nephrotoxicity is also stronger.The doctor should combine the actual situation of the patient.,rational choice of medication.