摘要:Objective To explore the efficacy and safety of entecavir and adefovir dipivoxil treatment for HBeAg positive chronic hepatitis B patients. Methods 90 cases of HBeAg positive chronic hepatitis patients admitted to our hospital who received antiviral treatment were randomly divided into observation group( n=46 ) and control group( n =44 ). The observation group was treated with entecavir orally,0. 5 mg,once daily;control group was given ADV 10 mg orally, once daily. The liver and kidney function, level of HBV-DNA,HBV serological markers and adverse drug reactions of the two groups were observed. Results Before treatment, ALT, HBV-DNA level of baseline data of the two groups had no significant difference( P > 0. 05 ). After 24 weeks and 48 weeks, HBeAg seroconversion rate in observation group was slightly higher than that of control group, there was no difference between the two groups ( P > 0. 05 ). At the same time,the HBV-DNA seroconversion rate in observation group was higher than that of control group( P <0. 01 ). After 48 weeks,there was significant difference in ALT normalization of both groups( P < 0. 05 ); and HBV-DNA high response rate of observation group was higher than that of control group( P <0. 05 ). There was no obvious adverse drug reactions in the two groups. Conclusion ETV is more suitable for HBV-DNA increased and severe hepatitis induced by HBV replication, and it is safe and efficient.%目的 探讨恩替卡韦、阿德福韦酯治疗HBeAg阳性慢性乙型肝炎的疗效和安全性.方法 选择我院收治的接受抗病毒治疗的HBeAg阳性慢性乙型肝炎患者90例,随机分为观察组与对照组,观察组46例给予恩替卡韦(ETV)0.5 mg,1次/d口服.对照组44例给予阿德福韦酯(ADV)10 mg,1次/d口服.观察两组的肝肾功能、HBV-DNA水平、HBV血清学标志物及药物不良反应.结果 治疗前两组ALT、HBV-DNA水平等基线资料比较,差异无统计学意义(P>0.05),治疗24、48周时,观察组HBeAg阴转率稍高于对照组,差异无统计学意义(P>0.05);治疗24、48周时,观察组HBV-DNA阴转率高于对照组,差异有统计学意义(P<0.01);治疗48周时,两组ALT复常率比较,差异有统计学意义(P<0.05);并且两组HBV-DNA高度应答率观察组高于对照组,两组比较差异有统计学意义(P<0.05).两组治疗中均未见明显药物不良反应.结论 ETV更适用于HBV-DNA明显升高者,对HBV复制所致的重型肝炎疗效显著,安全有效.