恩替卡韦和阿德福韦酯治疗HBeAg阳性慢性乙型肝炎近期疗效比较

目的探讨恩替卡韦、阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的疗效和安全性。方法选择我院收治的接受抗病毒治疗的HBeAg阳性慢性乙型肝炎患者90例,随机分为观察组与对照组,观察组46例给予恩替卡韦(ETV)0.5 mg,1次/d口服。对照组44例给予阿德福韦酯(ADV)10 mg,1次/d口服。观察两组的肝肾功能、HBV-DNA水平、HBV血清学标志物及药物不良反应。结果治疗前两组ALT、HBV-DNA水平等基线资料比较,差异无统计学意义(P>0.05),治疗24、48周时,观察组HBeAg阴转率稍高于对照组,差异无统计学意义(P>0.05);治疗24、48周时,观察组HBV-DNA阴转率高于对照组,差异有统计学意义(P<0.01);治疗48周时,两组ALT复常率比较,差异有统计学意义(P<0.05);并且两组HBV-DNA高度应答率观察组高于对照组,两组比较差异有统计学意义(P<0.05)。两组治疗中均未见明显药物不良反应。结论 ETV更适用于HBV-DNA明显升高者,对HBV复制所致的重型肝炎疗效显著,安全有效。

Comparison on efficacy of entecavir and adefovir dipivoxil treatment for HBeAg positive chronic hepatitis

Objective To explore the efficacy and safety of entecavir and adefovir dipivoxil treatment for HBeAg positive chronic hepatitis B patients.Methods 90 cases of HBeAg positive chronic hepatitis patients admitted to our hospital who received antiviral treatment were randomly divided into observation group(n=46)and control group(n=44).The observation group was treated with entecavir orally,0.5 mg,once daily;control group was given ADV 10 mg orally,once daily.The liver and kidney function,level of HBV-DNA,HBV serological markers and adverse drug reactions of the two groups were observed.Results Before treatment,ALT,HBV-DNA level of baseline data of the two groups had no significant difference(P>0.05).After 24 weeks and 48 weeks,HBeAg seroconversion rate in observation group was slightly higher than that of control group,there was no difference between the two groups(P> 0.05).At the same time,the HBV-DNA seroconversion rate in observation group was higher than that of control group(P<0.01).After 48 weeks,there was significant difference in ALT normalization of both groups(P<0.05);and HBV-DNA high response rate of observation group was higher than that of control group(P<0.05).There was no obvious adverse drug reactions in the two groups.Conclusion ETV is more suitable for HBV-DNA increased and severe hepatitis induced by HBV replication,and it is safe and efficient.