恩替卡韦与阿德福韦酯对核苷初治HBeAg阳性慢性乙型肝炎48周疗效比较

目的比较恩替卡韦(ETV)与阿德福韦酯(ADV)对核苷初治HBeAg阳性慢性乙型肝炎(chronic hepatitis B,CHB)患者48周时的疗效。方法 117例CHB患者随机分为ETV组和ADV组,分别给予0.5 mg/d ETV和10 mg/d ADV治疗,疗效的主要观测指标有:血清HBV-DNA、HbeAg转阴及ALT复常。结果 48周时,ETV与ADV组血清HBV-DNA转阴率分别为66.1%和18.2%,差异有统计学意义(P<0.05);两组ALT复常率分别为82.3%和56.4%,差异也有统计学意义(P<0.05);两组HBeAg转阴率(24.2%和16.4%)、抗-HBe转换率(8.06%和5.45%)及不良反应发生率(3.23%和3.64%),差异无统计学意义(P>0.05)。结论 ETV在促使CHB患者HBV-DNA转阴及ALT恢复正常方面显著优于ADV,在血清HBeAg转阴率、抗-HBe转换率及不良反应发生率方面二者相近。

Entecavir and Adefovir Dipivoxis of Nucleoside HBeAg Positive First Chronic Hepatitis b 48 Weeks Curative Effect Comparison

Objective To Compare entecavir （ETV） and Adefovir dipivoxil （ADV） for early mreleoside I-IBeAg positive chronic hepatitis B （CHB） patients at 48 weeks. Methods 117 CHB patients were randomly divided into ETV and ADV group, respectively give 0.5 mg/d ETV and 10 mg/d ADV treatment, the curative effect of the main outcome measure： serum HBV DNA, HBeAg overcast and ALT returned to normal. Results At 48 weeks, ETV and ADV group serum HBV-DNA overcast rate were 66.1% and 18.2% respectively, the difference was statistically significant （P〈0.05）; two groups of ALT after often rate were 82.3% and 56.4%respectively, also has a statistically significant difference （P〈0.05）; two groups of HBeAg turn rate （24.2% and 16.4%）, anti- HBe conversion rate （8.06% and 5.45%） and the incidence of adverse reactions （3.23% and 3.64%）, there was no statistically significant difference （P〉0.05）. Conclusion ETV in CHB patients returned to normal turn-HBV DNA and ALT is significantly superior to ADV, in serum HBeAg overcast rate, anti-HBe similarity conversion rate and the incidence of adverse reactions.