目的 比较替比夫定(LdT)和恩替卡韦(ETV)治疗HBeAg阳性的CHB,哪一个能较早地实现有限疗程.方法 60例HBeAg阳性的CHB患者随机分为LdT组和ETV组.在服药后第12周、24周及以后每24周复查,直至治疗和随访结束(4年,192周),检测血清HBV DNA定量、HBV血清标志物、肝功能、血清肌酸激酶.观察两组192周治疗结束时应答率及持续应答率以及患者达到停药标准所需的时间及费用.结果 192周时LdT组和ETV组治疗结束时应答率及持续应答率为43.3％ (13/30)vs 16.7％(5/30) 、36.7％ (11/30)vs10.0％ (3/30),差异有统计学意义(P＜0.05).达到停药标准LdT组平均治疗时间为167.2周,费用28089.6元,而ETV组平均治疗时间为186.4周,费用50887.2元.结论 治疗HBeAg阳性的CHB患者,实现有限疗程LdT更具有优势.%Objective To compare telbivudine (LdT) and entecavir ( ETV) in the treatment of HBeAg positive CHB , which can realize the course earlier limited. Methods 60 cases of HBeAg positive CHB patients were randomly divided into LdT group and ETV group. Serum HBV DNA quantitative, HBV markers, liver function and serum creatine kinase were detected in 12 weeks, 24 weeks after the medication and after every 24 weeks repeated, until the end of therapy and follow-up ( 4 years, 192 weeks). Response rates, sustained response rates and patients to achieve stopping criteria required time and cost were observed at the end of 192 weeks treatment in two groups. Results At 192 weeks, response rates and sustained response rates at the end of treatment in LdT group and ETV group were 43. 3% ( 13/30) vs 16.7% (5/30),36.7% (11/30) vs 10.0% (3/30), the difference was statistically significant (P<0.05). A-ehieved stop drug standard, LdT therapy group had a mean time of 167. 2 weeks, the cost was 28 089. 6 yuan, while ETV therapy group had a mean time of 186.4 weeks, the cost was 50 887.2 yuan. Conclusion Treatment of HBeAg positive CHB patients, LdT has more advantages to achieve limited course.
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