恩替卡韦与拉米夫定初次治疗慢性乙型肝炎疗效比较研究

发布时间：2018-11-10 07:43

【摘要】：目的观察恩替卡韦(ETV)与拉米夫定(LAM)初次治疗慢性乙型肝炎(CHB)的疗效。方法选取2013年3月至2015年2月该院门诊确诊的CHB患者104例,分为ETV组和LAM组,每组52例。ETV组予以ETV 0.5mg/d口服,LAM组予以LAM 100mg/d口服。观察两组患者治疗前,治疗12、24、48周谷氨酸氨基转移酶(ALT)、HBV-DNA、血清HBV标志物和HBeAg阴转率、HBsAg阴转率水平,记录药物相关不良事件发生率。结果治疗12周,ETV组患者ALT复常率明显高于LAM组,差异有统计学意义(P0.05);治疗24周,两组患者ALT复常率比较接近,差异无统计学意义(P0.05)。治疗12、24、48周,ETV组患者病毒学应答率、部分病毒学应答率均高于LAM组,差异有统计学意义(P0.01)。治疗12、24、48周,ETV组与LAM组患者HBeAg阴转率及HBeAg血清学转换率比较,差异无统计学意义(P0.05)。两组不良反应发生率均较低,未出现肾毒性、骨髓抑制、横纹肌溶解或其他不良事件,差异无统计学意义(P0.05)。结论 ETV治疗CHB在快速抑制HBV、早期促进ALT复常方面明显优于LAM,安全性良好。
[Abstract]:Objective to observe the efficacy of entecavir (ETV) and lamivudine (LAM) in the primary treatment of chronic hepatitis B (CHB). Methods 104 CHB patients diagnosed in our hospital from March 2013 to February 2015 were divided into ETV group and LAM group with 52 cases in each group. ETV 0.5mg/d was administered orally in ETV group and LAM 100mg/d in LAM group. The serum HBV markers, HBeAg negative conversion rate and HBsAg negative conversion rate of glutamate aminotransferase (ALT), HBV-DNA,) were observed before treatment and the incidence of drug-related adverse events were recorded. Results after 12 weeks of treatment, the recovery rate of ALT in ETV group was significantly higher than that in LAM group (P0.05), while at 24 weeks of treatment, the ALT recurrence rate of the two groups was close, the difference was not statistically significant (P0.05). The virological response rate and partial virological response rate in ETV group were significantly higher than those in LAM group (P0.01). There was no significant difference in HBeAg negative conversion rate and HBeAg serological conversion rate between ETV group and LAM group after 48 weeks of treatment (P0.05). The incidence of adverse reactions was lower in the two groups without nephrotoxicity, bone marrow suppression, rhabdomyolysis or other adverse events, the difference was not statistically significant (P0.05). Conclusion ETV is more safe than LAM, in the rapid inhibition of HBV, to promote the return of ALT in early stage.
【作者单位】：重庆市沙坪坝区人民医院消化内科;
【分类号】：R512.62

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