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中华消化病与影像杂志(电子版) ›› 2018, Vol. 08 ›› Issue (01) : 15 -18. doi: 10.3877/cma.j.issn.2095-2015.2018.01.004

所属专题: 文献

临床研究

替诺福韦酯与恩替卡韦对慢性乙型肝炎初治疗患者的疗效
尹丹萍1, 陈春明2,()   
  1. 1. 250031 济南军区总医院疾病预防控制科
    2. 250031 济南军区总医院医务部
  • 收稿日期:2017-11-20 出版日期:2018-02-01
  • 通信作者: 陈春明
  • 基金资助:
    2015年度济南军区总医院院长基金(2015QN02)

Efficacy of tenofovir and entecavir in initial treatment of chronic hepatitis B patients

Danping Yin1, Chunming Chen2,()   

  1. 1. Department of Disease Prevention and Control, Jinan Military General Hospital, Jinan 250031, China
    2. Department of Medical Administration, Jinan Military General Hospital, Jinan 250031, China
  • Received:2017-11-20 Published:2018-02-01
  • Corresponding author: Chunming Chen
  • About author:
    Corresponding author: Chen Chunming, Email:
引用本文:

尹丹萍, 陈春明. 替诺福韦酯与恩替卡韦对慢性乙型肝炎初治疗患者的疗效[J]. 中华消化病与影像杂志(电子版), 2018, 08(01): 15-18.

Danping Yin, Chunming Chen. Efficacy of tenofovir and entecavir in initial treatment of chronic hepatitis B patients[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2018, 08(01): 15-18.

目的

评估替诺福韦酯与恩替卡韦在治疗慢性乙型肝炎的疗效。

方法

纳入2010年6月至2015年6月入住济南军区总医院的慢性乙型肝炎的初治患者100例,采用随机数字表法分为观察组(替诺福韦酯)50例、对照组(恩替卡韦)50例,随访时间12、24个月,比较二者在HBV-DNA转阴率、HBeAg血清学转换率、丙氨酸转氨酶复常率、耐药率、安全性方面是否存在差异。

结果

与治疗前比较,观察组与对照组在随访观察12、24个月后各项指标较前明显改善,但二者在HBV-DNA转阴率(32/50 vs.28/50、46/50 vs.42/50)、HBeAg血清学转换率(4/28 vs.6/30、8/28 vs.12/30)、丙氨酸转氨酶复常率(42/50 vs.40/50、49/50 vs.46/50)、耐药率方面未见明显差异;但长期口服恩替卡韦对肾脏影响高于替诺福韦酯组,差异有统计学意义(P<0.05)。

结论

替诺福韦酯与恩替卡韦比较,二者在治疗慢性乙型肝炎效果相当,但长期口服药物安全性方面有优势,因此建议长期治疗慢性乙型肝炎临床运用替诺福韦酯作为首选方案。

Objective

To evaluate the efficacy of tenofovir(TDF)and entecavir(ETV)for the patients with chronic hepatitis B.

Methods

A total of 100 patients with chronic hepatitis B were included in the trial from June 2010 to June 2015 in Jinan Military General Hospital.All patients were divided into observation group(TDF)and control group(ETV)using random number table method, 50 patients in each group.The rates of hepatitis B virus(HBV)DNA suppression, hepatitis B virus e antigen(HBeAg)seroconversion, alanine transaminase(ALT)normalization, resistance and drug safety of the two groups were compared at 12, 24 months.

Results

At 12, 24 months, the various indexes of the two groups improved obviously.Compared with the ETV, TDF has the similarity in efficacy in the HBV DNA suppression(32/50 vs.28/50, 46/50 vs.42/50), HBeAg seroconversion(4/28 vs.6/30, 8/28 vs.12/30), ALT normalization(42/50 vs.40/50, 49/50 vs.46/50)and drug resistance rate.But the oral TDF was more safety with the longer administration in renal function compared with ETV.

Conclusion

TDF is very effective in the treatment of chronic hepatitis B which compared with ETV, but probably has more safety in the long-term administration, so we recommend the TDF as the primary drug in the long-term treatment of chronic hepatitis B.

表1 2组慢性乙型肝炎患者一般情况比较(例)
表2 2组慢性乙型肝炎患者在治疗周期结束后的病毒学、转氨酶以及血清学变化
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