替比夫定治疗HBeAg阳性慢性乙型肝炎的临床观察

目的:观察替比夫定治疗乙肝病毒e抗原(HBeAg)阳性慢性乙型肝炎的临床疗效和安全性。方法:82例HBeAg阳性慢性乙型肝炎患者按随机数字表法分为观察组(42例)和对照组(40例)。两组患者均给予护肝治疗、免疫调节、休息等常规治疗。在此基础上,对照组患者给予阿德福韦酯片10 mg,口服,qd;观察组患者给予替比夫定600 mg,口服,qd。两组患者疗程均为12个月。观察两组患者的临床疗效,治疗前后乙型肝炎病毒DNA(HBV-DNA)水平和HBV-DNA阴转率,HBeAg血清阴转率和转换率,治疗前后丙氨酸氨基转移酶(ALT)水平和ALT复常率及不良反应发生情况。结果:治疗后观察组患者总有效率、HBV-DNA阴转率、ALT复常率显著高于对照组,两组比较差异有统计学意义(P<0.05);治疗3、6、12个月后两组患者HBV-DNA、ALT均显著低于同组治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组患者HBeAg血清阴转率、HBeAg血清转换率、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:替比夫定治疗HBeAg阳性慢性乙型肝炎,疗效与安全性较好。

Clinical Observation of Telbivudine in the Treatment of HBeAg-positive Chronic Hepatitis B

OBJECTIVE：To observe clinical efficacy and safety of telbivudine in the treatment of HBeAg-positive chronic hepatitis B. METHODS：82 cases of HBeAg-positive chronic hepatitis B were randomly divided into observation group（42 cases）and control group（40 cases）. Both groups were given conventional therapy as liver protection therapy,immune regulation,rest,etc.Control group was additionally given Adefovir dipivoxil tablet 10 mg orally once a day;observation group was additionally given telbivudine 600 mg orally once a day. Treatment course of 2 groups lasted for 12 months. Clinical efficacy of 2 groups was observed. The level and negative rate of HBV-DNA,negative rate and conversion rates of serum HBeAg,the level and normalization rate of ALT and adverse drug reaction were observed before and after treatment. RESULTS：Total effective rate,negative rate of HBV-DNA and normalization rate of ALT in observation were significantly higher than in control group;there was statistical significance（P〈0.05）. The levels of HBV-DNA and ALT in 2 groups after 3,6 and 12 months of treatment were significantly lower than before,and those of observation group were lower than those of control group;there was statistical significance（P〈0.05）.The negative rate and transformation rate of HBV-DNA,the incidence of ADR in both group had no statistical significance（P〉0.05）. CONCLUSIONS：Telbivudine is effective and safe in the treatment of HBeAg-positive chronic hepatitis B.