替诺福韦与恩替卡韦治疗HBeAg阳性慢性乙型病毒性肝炎患者临床短期疗效

Comparison of short-term therapeutic effects between tenofovir and entecavir on HBeAg-positive patients with chronic hepatitis B

目的:观察替诺福韦(TDF)与恩替卡韦(ETV)治疗HBeAg阳性慢性乙型肝炎患者的抗病毒治疗效果。方法:收集2016年6月-2018年6月于我科门诊及住院治疗的80例慢性乙型肝炎(CHB)患者,随机分为TDF组(n=40)和ETV组(n=40)。TDF组应用富马酸替诺福韦二吡呋酯片治疗,ETV组患者应用恩替卡韦分散片治疗,随访48周。分析治疗24和48周后血清丙氨酸氨基转移酶(ALT)复常率、HBV DNA转阴率、HBeAg血清学转换率。结果:在治疗24周后,ETV组及TDF组患者的血清ALT复常率分别是55%和50%、HBV-DNA转阴率分别是70%和57. 5%,HBeAg血清学转换率分别是2. 5%和5%,差异无统计学意义(P分别为0. 654、0. 245和0. 556);在治疗48周后,ETV组及TDF组患者的血清ALT复常率分别是82. 5%和75%、HBV DNA转阴率分别是85%和82. 5%,HBeAg血清学转换率分别是10%和12. 5%,差异无统计学意义(P分别为0. 412、0. 762和0. 723)。结论:替诺福韦与恩替卡韦治疗HBeAg阳性慢性乙型肝炎患者48周的临床疗效无显著差别。

Objective:To observe and compare the therapeutic effects of tenofovir disoproxil fumarate(TDF)and entecavir(ETV)HBeAg-positive patients with chronic hepatitis B(CHB).Methods:A total of 80 patients with CHB in our hospital from June 2016 to June 2018 were enrolled.All patients were randomly divided into TDF group(n=40)and ETV group(n=40).All patients were followedup for 48 weeks.Rates of alamine aminotransferase(ALT)normalization,undetectable HBV DNA levels and HBeAg seroconversion between TDF group and ETV group were compared at the end of24 and 48 weeks.Results:At the end of 24 weeks,the rates of ALT normalization were 55%and50%respectively;the rates of undetectable HBV DNA levels were 70%and 57.5%,respectively;and the rates of HBeAg seroconversion were 2.5%and 5%respectively in ETV group and TDF group,between which there were no statistical difference(P=0.654,0.245 and 0.556,respectively).At the end of 48 weeks,the rates of ALT normalization were 82.5%and 75%respectively;the rates of undetectable HBV DNA levels were 85%and 82.5%respectively;and the rates of HBeAg seroconversion were 10%and 12.5%respectively in ETV group and TDF group,between which there were no statistical difference(P=0.412,0.762 and 0.723,respectively).Conclusion:TDF and ETV have similarly anti-viral therapeutic effects on HBeAg-positive patients with CHB.