恩替卡韦治疗慢性乙型肝炎的疗效

Effect of entecavir on treatment of hepatitis B

目的探讨恩替卡韦治疗慢性乙型肝炎治疗的疗效。方法选取2016年6月-2017年6月诊治的CHB患者80例,口服恩替卡韦分散片治疗48周,在治疗前、治疗12周、24周、36周、48周时定量检测患者血清HBsAg、HBV DNA变化。结果80例患者治疗有效率为85.00%;血清HBsAg和HBV DNA水平治疗12周、24周、36周、48周时有效组低于无效组(P<0.05),两组组内治疗前后比较差异有统计学意义(均P<0.05),血清HBsAg水平有效组在治疗12周时开始呈现下降趋势(P<0.05),无效组在治疗36周开始呈现下降趋势(P<0.05),血清HBV DNA水平两组均在治疗12周时开始呈现下降趋势(P<0.05);Pearson相关分析显示患者治疗后血清HBsAg和HBV DNA水平之间呈现正相关性(P<0.05);ROC曲线下面积显示在治疗24周时血清HBsAg水平为3.87 lg IU/ml,对抗病毒治疗疗效的预测敏感度为83.19%、特异度为77.20%。结论治疗前血清HBsAg水平与CHB患者恩替卡韦分散片抗病毒治疗疗效无关,治疗过程中血清HBsAg水平与治疗疗效密切相关,治疗24周时血清HBsAg水平明显降低的患者后期治疗疗效更好。

OBJECTIVE To explore the effect of entecavir on treatment of hepatitis B.METHODS A total of 80 patients with CHB who were treated from Jun 2016 to Jun 2017 were enrolled in the study,and the patients were treated with oral administration of entecavir dispersible tablets for 48 weeks.The levels of serum HBsAg and HBV DNA were quantitatively detected before the treatment and after the treatment for 12,24,36 and 48 weeks.RESULTS The effective rate of treatment of the 80 patients was 85.00%.The levels of serum HBsAg and HBV DNA of the effective group were significantly lower than those of the ineffective group after the treatment for 12,24,36 and 48 weeks(all P<0.05).The serum HBsAg level of the effective group began to decline after the treatment for 12 weeks(P<0.05),while the serum HBsAg level of the ineffective group began to decline after the treatment for 36 weeks(P<0.05).The serum HBV DNA level of both groups began to decline after the treatment for 12 weeks(P<0.05).Pearson correlation analysis showed that the serum HBsAg level was positively correlated with the HBV-DNA level after the treatment(P<0.05).The area under ROC curve indicated that the serum HBsAg level was 3.87 lg IU/ml on week 24 of treatment,the sensitivity was 83.19% for prediction of effect of antiviral therapy>and the specificity was 77.20%.CONCLUSION The serum HBsAg level is not associated with the effect of antiviral treatment with entecavir dispersible tablets before the treatment,wile the serum HBsAg level is closely associated with the curative effect during the treatment,and the patients whose serum HBsAg level is remarkably reduced on Week 24 of treatment have better later treatment effect.