富马酸替诺福韦二吡呋酯和恩替卡韦初治慢性乙肝的临床疗效对比

Clinical efficacy of tenofovir disoproxil fumarate tablets and entecavir in the treatment of patients with chronic hepatitis B

目的对比富马酸替诺福韦二吡呋酯和恩替卡韦治疗慢性乙型肝炎(乙肝)患者的临床效果。方法50例慢性乙肝患者,随机分为实验组与对照组,各25例。对照组接受恩替卡韦治疗,实验组接受富马酸替诺福韦二吡呋酯治疗。比较两组乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率、不良反应发生情况以及白细胞、中性粒细胞、血小板水平。结果实验组HBV-DNA转阴率100%高于对照组的20%,差异具有统计学意义(χ^(2)=33.3333,P<0.05)。实验组白细胞、中性粒细胞、血小板水平分别为(4.03±1.24)×10^(9)/L、(1.86±0.78)×10^(9)/L、(135.54±32.54)×10^(9)/L,与对照组的(4.11±1.02)×10^(9)/L、(2.01±0.73)×10^(9)/L、(140.43±34.66)×10^(9)/L比较,差异均具有统计学意义(P>0.05)。两组骨髓抑制、流感样症状、脱发发生率比较,差异均无统计学意义(P>0.05)。结论对慢性乙肝患者使用富马酸替诺福韦二吡呋酯治疗,与恩替卡韦比较,患者出现不良反应发生率并未升高,并提高患者治疗后HBV-DNA转阴率,具有安全、有效的特点,值得在临床中推广应用。

Objective To compare the clinical effect of tenofovir disoproxil fumarate tablets and entecavir in the treatment of patients with chronic hepatitis B.Methods A total of 50 patients with chronic hepatitis B were randomly divided into experimental group and control group,each with 25 cases.The control group was treated with entecavir,and the experimental group was treated with tenofovir disoproxil fumarate tablets.Both groups were compared in terms of negative-conversion rate of hepatitis B virus deoxyribonucleic acid(HBV-DNA),occurrence of adverse reactions,and the levels of white blood cells,neutrophils and platelets.Results The negative-conversion rate of HBV-DNA 100%in the experimental group was higher than 20%in the control group,and the difference was statistically significant(χ^(2)=33.3333,P<0.05).The levels of white blood cells,neutrophils,and platelets in the experimental group were(4.03±1.24)×10^(9)/L,(1.86±0.78)×10^(9)/L,(135.54±32.54)×10^(9)/L,which were(4.11±1.02)×10^(9)/L,(2.01±0.73)×10^(9)/L,(140.43±34.66)×10^(9)/L in the control group,and the differences were not statistically significant(P>0.05).There was no statistically significant difference in the incidence of bone marrow suppression,flu-like symptoms,and hair loss between the two groups(P>0.05).Conclusion Treatment of chronic hepatitis B patients with tenofovir disoproxil fumarate tablets will not increase the incidence of adverse reactions in patients compared with entecavir,and can improve the negative-conversion rate of HBV-DNA after treatment.It is safe and effective,and is worthy of clinical promotion and application.