替诺福韦与恩替卡韦治疗干扰素效果不佳的乙肝病毒阳性慢性肝炎效果对比

Comparison of the Effects of Tenofovir and Entecavir in the Treatment of Jepatitis B Virus Positive Chronic Hepatitis with Poor Interferon

目的探究替诺福韦与恩替卡韦治疗干扰素效果不佳的乙肝病毒(HBV)阳性慢性肝炎的疗效。方法选取徐州医科大学附属沭阳医院于2016年1月—2020年1月收治的干扰素效果不佳的乙肝病毒阳性慢性肝炎患者100例,按随机数字表法分为替诺福韦组和恩替卡韦组,各50例。观察两组治疗情况。结果替诺福韦组总有效率98.0%,恩替卡韦组总有效率96.0%,两组总有效率差异无统计学意义(P>0.05);治疗24周后,两组患者HBV DNA转阴率异无统计学意义(P>0.05),恩替卡韦组HBeAg转阴率、HBeAg血清转换率低于替诺福韦组,差异有统计学意义(P<0.05);两组患者治疗前肝功能指标差异无统计学意义 (P>0.05),治疗 24 周两组总胆红素 (TRil)、丙氨酸基转移酶 (ALT)、天冬氨酸转移酶(AST)均降低,差异无统计学意义(P>0.05);两组治疗前肝纤维化指标差异无统计学意义(P>0.05),治疗24周两组肝纤维化指标均降低,恩替卡韦组肝纤维化指标低于替诺福韦组,差异有统计学意义 (P<0.05)。结论 替诺福韦与恩替卡韦对乙肝病毒阳性慢性肝炎患者均有强抗病毒作用,耐药屏障高,替诺福韦HBeAg转阴率、HBeAg血清转换率较高,治疗后肝纤维化指标优于恩替卡韦,疗效更好。

Objective To explore the efficacy of tenofovir and entecavir in treating hepatitis B virus(HBV) positive chronic hepatitis with poor interferon. Methods 100 patients with hepatitis B virus-positive chronic hepatitis who were admitted to the hospital from January, 2016 to January, 2020 with poor interferon effect were selected and divided into tenofovir group and entecavir group according to the random number table, with 50 patients in each group. Treatment situations of two groups were compared. Results The total effective rate of the tenofovir group was 98.0%, and the total effective rate of the entecavir group was 96.0%. There was no significant difference in the total effective rate between the two groups(P>0.05). After 24 weeks of treatment, there was no statistically significant difference in the HBV DNA conversion rate between the two groups(P>0.05). The HBeAg conversion rate and HBeAg seroconversion rate in the entecavir group were lower than those in the tenofovir group, and the difference was statistically significant(P<0.05). The difference in liver function indexes between the two groups was not statistically significant(P>0.05). After 24 weeks of treatment, the total bilirubin(TRil), alanine transferase(ALT) and aspartate transferase(AST) of the two groups decreased, and the difference was not statistically significant(P>0.05). There was no statistically significant difference in liver fibrosis indexes between the two groups before treatment(P>0.05). After 24 weeks of treatment, the liver fibrosis indexes in the two groups were reduced, and the liver fibrosis indexes in the entecavir group were lower than the tenofovir group. There is statistical significance(P<0.05). Conclusion Tenofovir and entecavir have strong antiviral effects on patients with hepatitis B viruspositive chronic hepatitis, with a high resistance barrier, tenofovir HBeAg negative rate and HBeAg seroconversion rate are higher,liver fibrosis indicators after treatment are better than entecavir. The effect is better.