恩替卡韦与干扰素治疗HBeAg阳性慢性乙型肝炎的疗效

目的比较恩替卡韦与干扰素治疗HBeAg阳性慢性乙型肝炎的疗效。 方法入组69例患者分成两组，即恩替卡韦组（46例）与干扰素组（23例），收集HBeAg阳性慢性乙型肝炎患者抗病毒治疗12、24、36和48周时的血清；并检测血清HBV DNA、HBeAg、HBeAb、血清丙氨酸氨基转移酶（ALT）的含量。 结果在治疗12、24、36、48周时，恩替卡韦组患者血清HBV DNA低于检测下限的比率（82.6%、97.8%、97.8%和97.8%）显著高于干扰素组（34.8%、43.5%、47.8%和52.2%），差异均具有统计学意义（χ²= 15.8、24.7、21.9、19.2，P均= 0.00）；治疗24、36、48周时干扰素组患者HBeAg转阴率（34.8%、39.1%和43.5%）显著高于恩替卡韦组（4.3%、10.9%和17.4%），差异均有统计学意义（χ²= 9.1、5.9、5.4，P = 0.00、0.01、0.02）；治疗24、36、48周时干扰素组患者HBeAg血清学转换率（26.1%、30.4%和30.4%）显著高于恩替卡韦组（4.3%、4.3%和8.7%），差异均具有统计学意义（χ² = 5.1、7.0、3.9，P = 0.02、0.00、0.04）；各治疗时间点恩替卡韦组患者ALT复常率（87%、97.8%、100%和100%）显著高于干扰素组（34.8%、73.9%、73.9%和65.2%），差异均有统计学意义（χ² = 19.7、7.2、10.1、14.9，P均= 0.00）。 结论HBeAg阳性的慢性乙型肝炎患者，恩替卡韦治疗可获得更高的HBV DNA低于检测下限的比率，而干扰素治疗可获得更高的HBeAg转阴率及血清学转换率。

Comparison of effects of entecavir and interferon therapy for HBeAg-positive chronic hepatitis B

ObjectiveTo compare the therapeutic effects of entecavir and interferon for chronic hepatitis B patients with HBeAg-positive. MethodsThe 69 cases were divided into two groups, entecavir group (46 cases) and interferon group (23 cases). The serum of HBeAg-positive patients with chronic hepatitis B who accepted entecavir or interferon antiviral therapy for 12, 24, 36 and 48 weeks were collected. Meanwhile, the amounts of HBV DNA, HBeAg, HBeAb, serum alanine aminotransferase were detected, respectively. ResultsAt 12, 24, 36 and 48 weeks, the ratio of serum HBV DNA lower than the detection limit of entecavir group (82.6%, 97.8%, 97.8% and 97.8%) were significantly higher than those of interferon group (34.8%, 43.5%, 47.8% and 52.2%) (χ²= 15.8, 24.7, 21.9, 19.2; P all = 0.00). At 24, 36 and 48 weeks, HBeAg negative conversion rates of patients in interferon group (34.8%, 39.1% and 43.5%) were significantly higher than those of entecavir group (4.3%, 10.9% and 17.4%) (χ²= 9.1, 5.9, 5.4; P = 0.00, 0.01, 0.02). At 24, 36 and 48 weeks, HBeAg seroconversion rates of interferon group (26.1%, 30.4% and 30.4%) were significantly higher than those of entecavir group (4.3%, 4.3% and 8.7%) (χ²= 5.1, 7.0, 3.9; P = 0.02, 0.00, 0.04). At 12, 24, 36, 48 weeks, ALT normalization rates of patients in entecavir group (87%, 97.8%, 100% and 100%) were higher than that of interferon group (34.8%, 73.9%, 73.9% and 65.2%) (χ²= 19.7, 7.2, 10.1, 14.9; P all = 0.00). ConclusionsHBeAg-positive patients treated by entecavir could obtain higher ratio of serum HBV DNA lower than the detection limit, and those who accepted interferon could obtain higher rates of HBeAg negative conversion rate and seroconversion rate.