恩替卡韦治疗HBeAg 阳性乙型肝炎临床观察

目的:探讨恩替卡韦治疗HBeAg阳性乙型肝炎的疗效与安全性。方法:140例慢性乙肝患者随机分为2组:观察组予恩替卡韦0.5 mg/d,对照组予拉米夫定100 mg/d,疗程均为48周。观察两组HBV DNA阴转率、ALT复常率、HbeAg血清转换率以及不良反应发生情况。结果:在治疗12周后,观察组与对照组HBV DNA阴转率分别为47.1%、22.9%(P<0.01),ALT复常率分别为51.4%、31.4%(P<0.05),在治疗48周后,观察组与对照组HBV DNA阴转率分别为88.6%、48.6%(P<0.01),ALT复常率分别为90.0%、72.9%(P<0.01)。HbeAg血清转换率无统计学差异,两组患者未见严重不良反应。结论:恩替卡韦治疗HBeAg阳性乙肝患者,较拉米夫定起效快、作用强,且安全性好。

Clinical Observation of Entecavir in Treatment of HBeAg Positive Patients with Hepatitis B

Objective: To investigate efficacy and safety of entecavir on treatment of hepatitis B with positive HBeAg. Methods: 140 patients with chronic hepatitis B were randomly divided into 2 groups: study group were treated with entecavir 0.5 mg/d, and the control group were given lamivudine 100 mg/d. Both of the course was 48 weeks. HBV DNA negative conversion rates, ALT normalization rate, HBeAg seroconversion rates and incidence of adverse reactions were observed. Results: After 12 weeks of treatment, HBV DNA negative conversion rate of the observation and control group were 47.1% and 22.9% (P <0.01), respectively. ALT normalization rate were 51.4% and 31.4% (P <0.05), respectively. After 48 weeks of treatment, HBV DNA negative conversion rate of the observation and control group were 88.6% and 48.6% (P <0.01), respectively. ALT normalization rate were 90.0% and 72.9% (P <0.01), respectively. HBeAg seroconversion between the two groups were no significant difference. No serious adverse events occurred in the both groups. Conclusion: Compared with lamivudine, entecavir shows more rapid onset, stronger efficacy, and safety on treatment of hepatitis B with positive HBeAg.