Objective To investigate the antiviral efficacy of entecavir in the treatment of chronic hepatitis B with ALT <2 ULN .Methods A total of 138 patients with chronic hepatitis B was divided into two groups of A (ALT<2 ULN ,65 cases) and B(ALT≥2 ULN ,73 cases) .The antiviral treatment was performed with entecavir in both groups .The HBV DNA negative conversion rate , HBeAg negative conversion rate ,serum conversion rate and level of HBsAg were compared between two groups in 48 and 96 weeks after treatment .Results The HBV DNA negative conversion rate in groups of A and B in 48 weeks after treatment were 73.85% and 73.97% ,which in 96 weeks after treatment were 93.85% and 90.41% ,respectively .There was no significant difference in the HBV DNA negative conversion rate between two groups (P>0 .05) .The levels of HBsAg in 96 weeks after treatment were lower than those before in both groups ( P<0 .05 ) ,which were not significantly different between two groups(P>0 .05) .The HBeAg negative conversion rate and serum conversion rate in 48 weeks after treatment were slightly lower in group A than those in group B (P>0 .05) .The HBeAg serum conversion rate in 96 weeks after treatment was lower in group A than that in group B (P<0 .05) .Conclusion The antiviral efficacy of entecavir in the treatment of chronic hepatitis B with ALT<2 ULN is similar to that in the patients with ALT ≥2 ULN .But serum conversion rate of HBeAg is lower and a longer course of treatment is needed in the patients with ALT <2 ULN .%目的 探讨恩替卡韦治疗ALT<2 ULN慢性乙型肝炎的抗病毒效果.方法 根据ALT水平,138例慢性乙型肝炎患者分为观察组(ALT<2 ULN,65例)和对照组(ALT≥2 ULN,73例),均给予恩替卡韦抗病毒治疗,比较两组患者治疗48、96周血清HBV DNA阴转率、HBeAg阴转率及血清转换率与HBsAg水平.结果 治疗48周,观察组和对照组HBV DNA阴转率分别为73.85%和73.97%;治疗96周,观察组和对照组HBV DNA阴转率分别为93.85%和90.41%;两组HBV DNA阴转率均无统计学差异(P>0.05).观察组和对照组治疗96周血清HBsAg水平均较治疗前下降(P<0.05),但两组血清HBsAg水平无统计学差异(P>0.05).治疗48周,观察组HBeAg阴转率及血清转换率较对照组稍低(P>0.05);治疗96周,观察组HBeAg血清转换率低于对照组(P<0.05).结论 与ALT≥2 ULN慢性乙型肝炎患者相比,恩替卡韦治疗ALT<2 ULN慢性乙型肝炎患者有相似的抗病毒疗效,但HBeAg血清转换率较低,可能需要更长的疗程.
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