替比夫定和恩替卡韦治疗代偿期乙肝肝硬化疗效研究

摘要

Objective:To evaluate the clinic efficacy of Telbivudine and Entecavir treatment for Chronic Hepatitis B with liver fibrosis.Method:120 cases of Chronic Hepatitis B with liver fibrosis were randomly divided into two groups,based on conventional liver protection therapy,the observation group(n=60)treated with 600 mg of Telbivudine a day,the control group(n=60)treated with 0.5 mg of Entecavir a day.The course of treatment lasted 48 weeks. Result:(1)At week 48,The liver function and hepatic fibrosis index had been improved between two groups(P<0.01).(2)In observation group and control group,the HBV DNA negative rate was 86.7%and 88.3%respectively,which the HBeAg/antiHBe seroconversion rate of the observation group HBeAg/HBeAb was significantly higher than that of control group(35%vs.11.7%,P<0.01).(3)There was no severely adverse reaction occurred during treatment stage. Conclusion:Telbivudine could suppress HBV replication,improve liver function and HBeAg/antiHBe seroconversion rate,and it’s has good safety.%　　目的：探讨替比夫定和恩替卡韦治疗代偿期乙肝肝硬化的临床价值。方法：120例代偿期乙肝肝硬化患者随机分为两组，常规护肝治疗基础上，观察组（n=60）给予替比夫定600 mg/d；对照组（n=60）给予恩替卡韦0.5 mg/d。两组疗程均为48周。结果：（1）两组患者肝功能、肝纤维化指标较治疗前显著改善（P<0.01）；（2）观察组和对照组HBV DNA转阴率分别达到86.7%、88.3%，观察组HBeAg/HBeAb转换率显著高于对照组（35.0%vs 11.7%，P<0.01）；（3）治疗期间无严重不良反应发生。结论：替比夫定治疗代偿期乙肝肝硬化可有效抑制HBV DNA复制，改善肝功能，提高HBeAg血清学转换率，安全性佳。