恩替卡韦治疗33例慢性乙型肝炎疗效分析

目的 探讨恩替卡韦对33例乙型肝炎(乙肝)的治疗效果.方法 应用恩替卡韦0.5 mg/d口服治疗33例乙肝患者,其中慢性携带者7例,慢性轻度患者12例,慢性中度患者14例.主要检测血清HBV DNA水平,与基线值相比的平均下降量,HBV DNA阴转率(<3log10拷贝/ml);并同时检测ALT、AST复常率.结果 三组患者HBV DNA水平随治疗时间延长呈进行性下降,与基线相比的平均下降量也相应逐渐增加,三组两两比较差异无统计学意义.治疗24周后,携带者HBV DNA阴转率为57.1%,轻度患者为75.0%,中度患者为100.0%.其中,中度患者在治疗至12周、24周、36周时,HBV DNA阴转率显著高于携带者(P<0.05),仅在12周时HBV DNA阴转率高于轻度患者(P<0.01).中度患者48周时有5例达血清转换(35.7%),轻度患者在48周时有4例达血清转换(33.3%).轻度、中度患者分别在36周、24周时ALT/AST完全复常.结论 恩替卡韦治疗乙肝有较高疗效,安全,耐药风险低,值得推广.

Analysis of the curative efficacy in patients with chronic hepatitis B treated with entecavir

Objective To evaluate the curative efficacy in patients with chronic hepatitis B(CHB)treated with eraecavir(ETV).Method 33 patients with CHB(7 HBV-chronic carriers,12 mild cases and 14 moderate cases)were treated with entecavir 0.5 mg/d and detected serum HBV DNA,ALT,AST level and HBeAg seroconversion.Results Serum HBV DNA levels of 3 groups were dropped gradually with the therapy.The average declining counts compared with the baseline were increased too.There were no significant differences in the 3 groups compared with each other.At week 24 after treatment,the rates of HBV DNA reduced to negative were 57.1%,75.0%and 100.0%in HBV-chronic carriers group,mild group and moderate group respectively.The rates of HBV DNA reduced to negative in moderate group were higher than that of in HBV-chronic carriers group at 12,24,36 weeks(P<0.05).The rate of HBV DNA reduced to negative in moderate group was higher than that of in mild group at 12 weeks only(P<0.01).5 cases(35.7%)procured HBeAg seroconversion at 48 weeks in moderate group.4 cases(33.3%)procured HBeAg seroconversion at 48 weeks in mild group.ALT/AST recovered to normal in mild group at 36 weeks,in moderate group at 24 weeks respectively.Conclusions ETV is efficacy and safety in patients with chronic hepatitia B.