CAJ | 학술논문

目的：比较恩替卡韦单药与拉米夫定和阿德福韦联合治疗慢性乙型肝炎的疗效。方法：选择2008年10月至2012年3月我院收治的慢性乙型肝炎患者261例，按HBeAg情况分为HBeAg阳性组和阴性组，分别比较两组内单药与联合治疗的疗效差异，对治疗前和治疗后6个月的ALT复常率、HBV DNA转阴率以及HBeAg转阴率进行分析。结果：HBeAg阳性组，单药和联合治疗的ALT复常率(75%和75%)和HBeAg转阴率(4.7%和9.4%)差异无统计学意义（P>0.05）,但在HBV DNA转阴率（82.8%和62.5%）方面，单药效果优于联合治疗（P<0.05）；HBeAg阴性组中，单药和联合治疗的ALT复常率（89.7%和76.0%，P>0.05），但在HBV DNA转阴率（97.4%和76.0%）方面，单药效果优于联合治疗（P<0.05）。结论：恩替卡韦单药与拉米夫定联合阿德福韦在治疗慢性乙型肝炎方面均有良好疗效，在ALT复常率和HBeAg转阴率方面的疗效差异无统计学意义，在HBV DNA转阴率方面，恩替卡韦单药疗效更好。
목적：비교은체잡위단약여랍미부정화아덕복위연합치료만성을형간염적료효。방법：선택2008년10월지2012년3월아원수치적만성을형간염환자261례，안HBeAg정황분위HBeAg양성조화음성조，분별비교량조내단약여연합치료적료효차이，대치료전화치료후6개월적ALT복상솔、HBV DNA전음솔이급HBeAg전음솔진행분석。결과：HBeAg양성조，단약화연합치료적ALT복상솔(75%화75%)화HBeAg전음솔(4.7%화9.4%)차이무통계학의의（P>0.05）,단재HBV DNA전음솔（82.8%화62.5%）방면，단약효과우우연합치료（P<0.05）；HBeAg음성조중，단약화연합치료적ALT복상솔（89.7%화76.0%，P>0.05），단재HBV DNA전음솔（97.4%화76.0%）방면，단약효과우우연합치료（P<0.05）。결론：은체잡위단약여랍미부정연합아덕복위재치료만성을형간염방면균유량호료효，재ALT복상솔화HBeAg전음솔방면적료효차이무통계학의의，재HBV DNA전음솔방면，은체잡위단약료효경호。
Objective: To compare treatment outcome between monotherapy with entecavir and combination therapy with lamivudine plus adefovir in the treatment of chronic hepatitis B. Methods: 261 chronic hepatits B patients, who received treatment in our hospital from October 2008 to March 2012, were divided into HBeAg(+) group and HBeAg(-) group. Each group contains monotherapy and combination therapy. Before and six months after treatment, the clinical data were recorded, including ALT normalization rate, hepatitis B virus(HBV )DNA clearance rate, and HBeAg clearance rate, to compare the treatment outcome between different therapys in each group. Results:After six months of treatment, the ALT normalization rate(HBeAg(+)group: 75% vs75%; HBeAg(-)group: 89.7% vs 76.0% ) had no signiifcant difference between different therapys in both group(P>0.05). The HBeAg clearance rate(4.7% vs 9.4%) showed no signiifcant difference between the Entecavir only and lamivudine plus adefovir in HBeAg(+) group(P>0.05). The HBV DNA clearance rate(HBeAg(+)group)82.8%vs62.5%(HBeAg(-)group:97.4%vs 76.0%) was signiifcantly higher in entecavir only than in lamivudine plus adefovir (P<0.05). Conclusion:Both monotherapy with entecavir and combination therapy with lamivudine plus aderovir produce a good clinical effect in chronic hepatitis B patients. Monotherapy seems to have advantages in HBV DNA clearance rate.