恩替卡韦与阿德福韦酯对HBeAg阳性慢性乙型肝炎患者临床疗效的比较

目的：比较恩替卡韦（ETV）和阿德福韦酯（ADV）治疗HBeAg阳性慢性乙型肝炎（CHB）患者48周的疗效和安全性。方法：选取接受抗病毒治疗的HBeAg阳性CHB患者81例，随机分为治疗组（47例）和对照组（34例）。治疗组给予ETV0．5mg，1次／d口服；对照组给予ADV10mg，1次／d口服。所有患者治疗不少于48周。分别于治疗前、治疗后24周、48周检测所有患者肝功能、肾功能，血清乙型肝炎病毒（HBV）DNA水平，HBV血清学标志物，并观察药物不良反应。结果：治疗24周时，治疗组和对照纽丙氨酸氨基转移酶（ALT）复常率分别为83．0％和76．5％（x^2=0．527，P〉0．05）；HBVDNA阴转率分别为44．7％和17．6％（^2=6．488，P〈0．05）；血清HBeAg阴转率分别为8．5％和5．9％（x^2=0．199，P〉0．05）。治疗48周时，治疗组和对照组ALT复常率分别为89．4％和88．2％（x^2=0．025，P〉0．05）；HBVDNA阴转率分别为57．4％和23．5％（x^2=-9．249，P〈0．05）；血清HBeAg阴转率分别为12．8％和11．8％（x^2=0．018，P〉0．05）。治疗过程中未发现与治疗药物相关的严重不良反应以及耐药病例。结论：ETV抑制血清中乙肝病毒复制的能力较ADV更迅速、更强效，安全性与ADV相当。

Comparison of the efficacy of entecavir therapy and adefovir for patients with HBeAg positive chronic hepatitis B

Objective:To compare the efficacy and safety of entecavir(ETV) and adefovir(ADV) for the patients with HBeAg positive chronic hepatitis B.Methods: 81 CHB patients with HBeAg positive were treated with daily dose of ETV 0.5 mg(47 patients) or ADV 10 mg(34 patients) randomly for at least 48 weeks.Liver and renal functions were tested,serum HBV DNA,hepatitis B viral markers were detected for all patients before treatment,for 24 weeks,48 weeks treatment,respectively.Adverse drug reactions were observed.Results: At week 24,the normalization of ALT in the two groups was similar(83.0% vs 76.5%,χ2=0.527,P>0.05);HBV DNA negative rate in ETV group was significantly higher than that in ADV group(44.7% vs 17.6%,χ2=6.488,P<0.05);HBeAg negative rate was similar in the two groups(8.5% vs 5.9%,χ2=0.199,P>0.05).At week 48,the normalization of ALT in the two groups was similar(89.4% vs 88.2%,χ2=0.025,P>0.05);HBV DNA negative rate in ETV group was significantly higher than that in ADV group(57.4% vs 23.5%,χ2=9.249,P<0.05);HBeAg negative rate was similar in the two groups(12.8% vs 11.8%,χ2=0.018,P>0.05).There was no serious drug-related adverse reactions and resistent cases during the treatment.Conclusion: ETV is more potent to suppress HBV replication,while the safety profile is comparable to ADV.