中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
9期
1109-1112
,共4页
金瑞%陈新月%张鸿飞%郭新会%李秀惠%丁惠国%赵国庆%陈晓%佟立新
金瑞%陳新月%張鴻飛%郭新會%李秀惠%丁惠國%趙國慶%陳曉%佟立新
금서%진신월%장홍비%곽신회%리수혜%정혜국%조국경%진효%동립신
慢性乙型肝炎%替比夫定%拉米夫定%肌酸激酶
慢性乙型肝炎%替比伕定%拉米伕定%肌痠激酶
만성을형간염%체비부정%랍미부정%기산격매
Chronic hepatitis B%Telbivudine%Lamivudine%Creatine kinase
目的 观察替比夫定治疗HBeAg阳性慢性乙型肝炎的临床疗效及安全性.方法 对210例门诊治疗的HBeAg阳性慢性乙型肝炎患者进行回顾性分析,将其根据治疗方法分为2组,替比夫定组104例(应用替比夫定600 mg/d治疗),拉米夫定组106例(应用拉米夫定100 mg/d治疗).2组均治疗52周,观察两药对血清HBV DNA、HBV血清学标志物、肝脏生物化学指标的影响及安全性.根据患者治疗12和24周HBV DNA的水平来预测影响疗效的因素.结果 治疗52周后,替比夫定组血清HBV DNA检测不到率、HBeAg转阴率、HBeAg转换率、ALT复常率、病毒学突破率和病毒学反弹率均优于拉米夫定组,差异性有统计学意义[70.2％ (73/104)比56.6％ (60/106)；35.6％ (37/104)比12.3％ (13/106)；22.1％ (23/104)比11.3％ (12/106);77.9％ (81/104)比55.7％ (59/106);6.7％ (7/104)比16.0％ (17/106);2.9％ (3/104)比10.4％ (11/106)；P ＜0.01或P＜0.05].替比夫定治疗24周,HBV DNA水平＜500拷贝/ml的患者,52周HBV DNA检测不到率和病毒学反弹率,优于≥500拷贝/ml的患者,差异具有统计学意义(P＜0.05).结论 替比夫定对HBeAg阳性慢性乙型肝炎的疗效优于拉米夫定,能迅速持续抑制HBV的复制,使HBeAg转换,肝功能恢复正常,不良反应较少,患者耐受性好,可以长期治疗慢性乙型肝炎,在治疗中应注意监测肌酸激酶.
目的 觀察替比伕定治療HBeAg暘性慢性乙型肝炎的臨床療效及安全性.方法 對210例門診治療的HBeAg暘性慢性乙型肝炎患者進行迴顧性分析,將其根據治療方法分為2組,替比伕定組104例(應用替比伕定600 mg/d治療),拉米伕定組106例(應用拉米伕定100 mg/d治療).2組均治療52週,觀察兩藥對血清HBV DNA、HBV血清學標誌物、肝髒生物化學指標的影響及安全性.根據患者治療12和24週HBV DNA的水平來預測影響療效的因素.結果 治療52週後,替比伕定組血清HBV DNA檢測不到率、HBeAg轉陰率、HBeAg轉換率、ALT複常率、病毒學突破率和病毒學反彈率均優于拉米伕定組,差異性有統計學意義[70.2％ (73/104)比56.6％ (60/106)；35.6％ (37/104)比12.3％ (13/106)；22.1％ (23/104)比11.3％ (12/106);77.9％ (81/104)比55.7％ (59/106);6.7％ (7/104)比16.0％ (17/106);2.9％ (3/104)比10.4％ (11/106)；P ＜0.01或P＜0.05].替比伕定治療24週,HBV DNA水平＜500拷貝/ml的患者,52週HBV DNA檢測不到率和病毒學反彈率,優于≥500拷貝/ml的患者,差異具有統計學意義(P＜0.05).結論 替比伕定對HBeAg暘性慢性乙型肝炎的療效優于拉米伕定,能迅速持續抑製HBV的複製,使HBeAg轉換,肝功能恢複正常,不良反應較少,患者耐受性好,可以長期治療慢性乙型肝炎,在治療中應註意鑑測肌痠激酶.
목적 관찰체비부정치료HBeAg양성만성을형간염적림상료효급안전성.방법 대210례문진치료적HBeAg양성만성을형간염환자진행회고성분석,장기근거치료방법분위2조,체비부정조104례(응용체비부정600 mg/d치료),랍미부정조106례(응용랍미부정100 mg/d치료).2조균치료52주,관찰량약대혈청HBV DNA、HBV혈청학표지물、간장생물화학지표적영향급안전성.근거환자치료12화24주HBV DNA적수평래예측영향료효적인소.결과 치료52주후,체비부정조혈청HBV DNA검측불도솔、HBeAg전음솔、HBeAg전환솔、ALT복상솔、병독학돌파솔화병독학반탄솔균우우랍미부정조,차이성유통계학의의[70.2％ (73/104)비56.6％ (60/106)；35.6％ (37/104)비12.3％ (13/106)；22.1％ (23/104)비11.3％ (12/106);77.9％ (81/104)비55.7％ (59/106);6.7％ (7/104)비16.0％ (17/106);2.9％ (3/104)비10.4％ (11/106)；P ＜0.01혹P＜0.05].체비부정치료24주,HBV DNA수평＜500고패/ml적환자,52주HBV DNA검측불도솔화병독학반탄솔,우우≥500고패/ml적환자,차이구유통계학의의(P＜0.05).결론 체비부정대HBeAg양성만성을형간염적료효우우랍미부정,능신속지속억제HBV적복제,사HBeAg전환,간공능회복정상,불량반응교소,환자내수성호,가이장기치료만성을형간염,재치료중응주의감측기산격매.
Objective To observe the clinical efficacy and safety of telbivudine in treating HBeAg-positive chronic hepatitis B. Methods Totally 210 cases of outpatients with HBeAg-positive chronic hepatitis B were divided into two groups;104 cases of them were treated with telbivudine (600 mg/d)and 106 cases of them were treated with lamivudine (100 mg/d)for 52 weeks.Serum HBV DNA,the serum HBV markers and biochemical indicators of the liver were observed.We also observed the factors that may influence the curative effect on the 12nd week and the 24th week. Results After 52 weeks of treatment,serum HBV DNA undetectable rate,HBeAg negative conversion rate,HBeAg conversion rate,the ALT normalization rates,viral breakthrough rates and virological rebound rate were superior to those lamivudine with telbivudine. The differences were statistically significant [ 70.2％ (73/104)vs 56.6％ (60/106 );35.6％ (37/104 )vs 12.3％ (13/106 );22.1％ (23/104 )vs 11.3％ (12/106 );77.9％ (81/104 )vs 55.7％ (59/106 );6.7％ (7/104 )vs 16.0％ (17/106 );2.9％ (3/104 )vs 10.4％ (11/106);P ＜0.01 or P＜0.05 ].After 24 weeks of treatment with telbivudine,the patients with HBV DNA below 500 copies/ml showed better HBV DNA undetectability rate and viral rebound rate at the 52nd week than those with HBV DNA above 500 copies/ml. The difference was significant (P＜0.05 ). Conclusion Telbivudine in treatment of HBeAg-positive chronic hepatitis B is superior to lamivudine,can rapidly and sustainly suppress HBV replication,HBeAg conversion,make liver function return to normal,has few adverse events,good patient' tolerance,can long-term treat chronic hepatitis B.
