围替比夫定治疗慢性乙型肝炎期的实验观察

目的 实验观察替比夫定治疗慢性乙肝的疗效。方法83 例慢性乙肝患者分成HBeAg阴性组(40例)和HBeAg阳性组（43例），均首次给予替比夫定抗病毒治疗48周，于治疗0、4、12、24、48周时检测HBV DNA、ALT水平、乙肝二对半，分析上述时间点两组患者HBV DNA阴转率、ALT复常率、e抗原转阴率及血清转换率（又称血清乙肝标志物转换率）。结果 HBeAg阴性组治疗4、12、24、48周时HBV DNA 阴转率分别为：25%、47.5%、77.5%、87.5%；ALT的复常率分别为：5%、55%、80%、97.5%；HBeAg阳性组治疗4、12、24、48周时的HBV DNA阴转率分别为：2.32%、16.27%、48.83%、67.44%；ALT的复常率分别为2%、51.16%、77.27%、95.23%；e抗原转阴率分别为；0、16.27%、32.55%、48.83%；血清学转换率分别为：0、11.63%、18.60%、34.88%。结论 替比夫定可明显抑制HBV DNA 的复制，促使ALT回复正常，近期疗效好，对e抗原阴性的初治病人HBV DNA的阴转率更高。

Experimental observation of telbivudine treatment on chronic hepatitis B

Objective To observe the therapeutic efficacy of telbivudine treatment on patients with chronic hepatitis B．Methods 83 patients, who were given telbivudine treatment for the first time, were divided into HbeAg negative group (40 cases) and positive group (43 cases),and the treatment lasts 48 weeks.To detect their HBV DNA、ALT level、 HBV-M simultaneously beforehand and at the 4th,12th,24th,and 48th weeks, analyzing their HBV DNA undetectable rate、ALT normalization rate、HBeAg undetectable rate and seroconversaion rate (HBV-M conversion ratio) at the time. Results the HBV DNA undetectable rate of the HbeAg negative group at the 4th,12th,24th,and 48th weeks were 25%、47.5%、77.5%、87.5% respectively；the ALT normalization rate were 5%、55%、80%、97.5% respectively；the HBV DNA undetectable rate of the HbeAg positivegroup at the 4th, 12th, 24th and 48th weeks were 2.32%、16.27%、48.83%、67.44% respectively；the ALT normalization rate were 2%、51.16%、77.27%、95.23% respectively；the HBeAg undetectable rate were 0、16.27%、32.55%、48.83% and the seroconversion rate were 0、11.63%、18.60%、34.88%.Conclusion Telbivudine Can effectively inhibit replication of hepatitis B virus and improve undetectable rate of HBV DNA and promote normalization rate of ALT,In addition,telbivudine treatment is safe and well toleran,and at every time piont of the treatment ,the HBV DNA undetectable rate of the HbeAg negative group was significantly higher than that in HbeAg positive group.