替诺福韦与恩替卡韦初始治疗慢性乙型肝炎的效果比较

Comparison on efficacy of tenofovir and entecavir in the initial treatment of chronic hepatitis B

目的探讨替诺福韦(TDF)与恩替卡韦(ETV)初始治疗慢性乙型肝炎(CHB)的效果差异。方法抽取2019年11月至2021年11月驻马店市中心医院收治的CHB患者100例,以双色球法分为对照组与观察组,每组50例。对照组采用ETV初始治疗,观察组采用TDF初始治疗,比较两组的治疗效果,丙氨酸氨基转移酶(ALT)、乙肝病毒脱氧核糖核酸(HBV-DNA)、炎症因子水平,HBV-DNA阴转率、ALT复常率及不良反应发生情况。结果治疗前,两组ALT、炎症因子水平比较差异未见统计学意义(P>0.05);治疗12周时,观察组ALT、HBV-DNA、炎症因子水平均低于对照组(P均<0.05);治疗12周时,观察组HBV-DNA阴转率(54.00%,27/50)、ALT复常率(56.00%,28/50)高于对照组(30.00%,15/50;32.00%,16/50),P<0.05,但治疗36周时,两组HBV-DNA阴转率、ALT复常率比较差异未见统计学意义(P>0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论CHB采取TDF初始治疗与ETV初始治疗均可取得不错的效果,但TDF初始治疗可更快促进ALT、HBV-DNA、炎症因子水平降低,而HBV-DNA可更快阴转,且ALT复常率高,不明显增加不良反应。

Objective To investigate the difference in efficacy between tenofovir(TDF)and entecavir(ETV)in the initial treatment of chronic hepatitis B(CHB).Methods A total of 100 CHB patients treated in Zhumadian Central Hospital from November 2019 to November 2021 were selected,and they were divided into control group and observation group by the two-color ball method,with 50 cases in each group.The control group was treated with ETV initially,and the observation group was treated with TDF initially.The therapeutic effects,alanine aminotransferase(ALT),hepatitis B virus(HBV-DNA),inflammatory factor levels,negative conversion rate of HBV-DNA,ALT normalization rate and adverse reactions of the two groups were compared.Results Before treatment,there was no significant difference in levels of ALT and inflammatory factors between the two groups(P>0.05).After 12 weeks of treatment,the levels of ALT,HBV-DNA,and inflammatory factors in the observation group were lower than those in the control group(all P<0.05).After 12 weeks of treatment,the negative conversion rate of HBV-DNA and renormalization rate of ALT in the observation group(54.00%,27/50;56.00%,28/50)were higher than those in the control group(30.00%,15/50;32.00%,16/50),P<0.05.However,there was no significant difference in negative conversion rate of HBV-DNA and normalization rate of ALT between the two groups after 36 weeks of treatment(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Both TDF and ETV can achieve good therapeutic effects in the initial treatment of CHB patients.TDF initial treatment can promote the reduction of ALT,HBV-DNA and inflammatory factors faster,accelerate process of HBV-DNA converting to negative,increase normalization rate of ALT,without significant increase in adverse reactions.