替比夫定治疗HBeAg阳性慢性乙型肝炎48周疗效评估

摘要

Objective To investigate the effect of telbivudine treatment in patients with HBeAg-positive hepatitis B. Methods 48 patients with HBeAg-positive hepatitis B were de novo treated with telbivudine. At 12, 24 and 48 weeks after treatment, the biochemical, virological and serological responses were evaluated. Results At 12,24 and 48 weeks after treatment, the serum response rates were 22.9% ,56.2% ,64.6% ,respectively; the virological response rates were 47.9% ,85.4% ,89.6% .respectively. They were significantly correlated to baseline ALT,AST and HBV DNA levels; the biochemical response rates were 47.9% ,83.3% ,95.8% .respectively. Biochemical response at week 24 was correlated to baseline ALT and AST levels; serum creatine kinase levels were elevated to 192 to 610U/L in 3 patients without muscle symptomes. Conclusions Telbivudine has beneficial effects in chronic hepatitis B patients with HBeAg positive.%目的 探讨HBeAg阳性慢性乙型肝炎初治患者服用替比夫定的近期疗效.方法 给予48例HBeAg阳性慢性乙型肝炎初治患者口服替比夫定治疗48周,观察患者应答情况.结果 在治疗12周、24周和48周时,患者血清学应答率分别为22.9%、56.2%和64.6%,它们与基线ALT、AST和HBV DNA水平无相关;12周、24周、48周病毒学应答率分别为47.9%、85.4%、89.6%,与基线ALT、AST、HBV DNA水平无相关性(P>0.05),48周病毒学应答率高低与24周呈正相关(P<0.01);12周、24周、48周生化学应答率分别为47.9%、83.3%、95.8%,24周生化学应答发生与否与基线ALT、AST水平有相关性,发生生化学应答者治疗前ALT和AST水平明显高于未发生生化学应答者(P<0.05).本组患者中有3例发生无肌肉症状的磷酸肌酸激酶升高(192～610U/L).结论 替比夫定治疗HBeAg阳性慢性乙型肝炎48周疗效满意,耐受性较好.