恩替卡韦与阿德福韦酯对核苷初治HBeAg阳性慢性乙型肝炎48周疗效比较

摘要

Objective To Compare entecavir (ETV) and Adefovir dipivoxil (ADV) for early nucleoside HBeAg positive chronic hepatitis B (CHB) patients at 48 weeks.Methods 117 CHB patients were randomly divided into ETV and ADV group, respectively give 0.5 mg/d ETV and 10 mg/d ADV treatment, the curative effect of the main outcome measure: serum HBV DNA, HBeAg overcast and ALT returned to normal. Results At 48 weeks, ETV and ADV group serum HBV-DNA overcast rate were 66.1% and 18.2% respectively, the difference was statistically signiifcant (P<0.05); two groups of ALT after often rate were 82.3% and 56.4% respectively, also has a statistically signiifcant difference (P<0.05); two groups of HBeAg turn rate (24.2% and 16.4%), anti-HBe conversion rate (8.06% and 5.45%) and the incidence of adverse reactions (3.23% and 3.64%), there was no statistically signiifcant difference (P>0.05). Conclusion ETV in CHB patients returned to normal turn-HBV DNA and ALT is signiifcantly superior to ADV, in serum HBeAg overcast rate, anti-HBe similarity conversion rate and the incidence of adverse reactions.%目的：比较恩替卡韦（ETV）与阿德福韦酯（ADV）对核苷初治HBeAg阳性慢性乙型肝炎（chronichepatitisB，CHB）患者48周时的疗效。方法117例CHB患者随机分为ETV组和ADV组，分别给予0.5mg/dETV和10mg/dADV治疗，疗效的主要观测指标有：血清HBV-DNA、HbeAg转阴及ALT复常。结果48周时，ETV与ADV组血清HBV-DNA转阴率分别为66.1%和18.2%，差异有统计学意义（P<0.05）；两组ALT复常率分别为82.3%和56.4%，差异也有统计学意义（P<0.05）；两组HBeAg转阴率（24.2%和16.4%）、抗-HBe转换率（8.06%和5.45%）及不良反应发生率（3.23%和3.64%），差异无统计学意义（P>0.05）。结论ETV在促使CHB患者HBV-DNA转阴及ALT恢复正常方面显著优于ADV，在血清HBeAg转阴率、抗-HBe转换率及不良反应发生率方面二者相近。