替比夫定治疗HBeAg阳性慢性乙型肝炎48周疗效评估

目的探讨HBeAg阳性慢性乙型肝炎初治患者服用替比夫定的近期疗效。方法给予48例HBeAg阳性慢性乙型肝炎初治患者口服替比夫定治疗48周,观察患者应答情况。结果在治疗12周、24周和48周时,患者血清学应答率分别为22.9%、56.2%和64.6%,它们与基线ALT、AST和HBV DNA水平无相关;12周、24周、48周病毒学应答率分别为47.9%、85.4%、89.6%,与基线ALT、AST、HBV DNA水平无相关性(P>0.05),48周病毒学应答率高低与24周呈正相关(P<0.01);12周、24周、48周生化学应答率分别为47.9%、83.3%、95.8%,24周生化学应答发生与否与基线ALT、AST水平有相关性,发生生化学应答者治疗前ALT和AST水平明显高于未发生生化学应答者(P<0.05)。本组患者中有3例发生无肌肉症状的磷酸肌酸激酶升高(192～610U/L)。结论替比夫定治疗HBeAg阳性慢性乙型肝炎48周疗效满意,耐受性较好。

The efficacy of telbivudine treatment in patients with HBeAg-positive hepatitis B

Objective To investigate the effect of telbivudine treatment in patients with HBeAg-positive hepatitis B.Methods 48 patients with HBeAg-positive hepatitis B were de novo treated with telbivudine.At 12,24 and 48 weeks after treatment,the biochemical,virological and serological responses were evaluated.Results At 12,24 and 48 weeks after treatment,the serum response rates were 22.9%,56.2%,64.6%,respectively;the virological response rates were 47.9%,85.4%,89.6%,respectively.They were significantly correlated to baseline ALT,AST and HBV DNA levels;the biochemical response rates were 47.9%,83.3%,95.8%,respectively.Biochemical response at week 24 was correlated to baseline ALT and AST levels;serum creatine kinase levels were elevated to 192 to 610U/L in 3 patients without muscle symptomes.Conclusions Telbivudine has beneficial effects in chronic hepatitis B patients with HBeAg positive.