中华实验和临床感染病杂志(电子版)
中華實驗和臨床感染病雜誌(電子版)
중화실험화림상감염병잡지(전자판)
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
5期
614-617
,共4页
肝炎,乙型,慢性%恩替卡韦%拉米夫定%Meta分析
肝炎,乙型,慢性%恩替卡韋%拉米伕定%Meta分析
간염,을형,만성%은체잡위%랍미부정%Meta분석
Chronic hepatitis B%Entecavir%Lamivudine%Meta-analysis
目的:评价恩替卡韦(ETV)治疗中国慢性乙型肝炎患者的疗效。方法检索2006年1月至2013年10月所有以ETV为试验组和拉米夫定(LAM)为对照组的随机对照试验(RCT)资料,查阅所有文献的参考文献作为补充,两名研究者独立采用Jadad评分对全部纳入文献进行质量评价,异质性分析使用χ2检验,以比值比(OR)为效应量进行Meta分析。结果共有7篇RCT文献纳入本研究,其中中文文献3篇,英文文献4篇,研究结果显示,ETV组的HBV DNA低于检测下限的比率和ALT复常率均高于LAM组(OR=4.12,95%CI:3.37~5.05,P<0.001;OR=1.60,95%CI:1.31~1.96,P<0.001)。ETV组的ALT复燃率低于LAM组(OR=0.56,95%CI:0.35~0.91,P=0.02)。两种药物的不良反应发生率相当(OR=1.06,95%CI:0.85~1.31,P=0.61)。结论恩替卡韦可强效抑制慢性乙型肝炎患者体内的HBV DNA、提高生化学应答、肝组织学改善率,同时具有和其他核苷酸类药物一样的安全性和耐受性。
目的:評價恩替卡韋(ETV)治療中國慢性乙型肝炎患者的療效。方法檢索2006年1月至2013年10月所有以ETV為試驗組和拉米伕定(LAM)為對照組的隨機對照試驗(RCT)資料,查閱所有文獻的參攷文獻作為補充,兩名研究者獨立採用Jadad評分對全部納入文獻進行質量評價,異質性分析使用χ2檢驗,以比值比(OR)為效應量進行Meta分析。結果共有7篇RCT文獻納入本研究,其中中文文獻3篇,英文文獻4篇,研究結果顯示,ETV組的HBV DNA低于檢測下限的比率和ALT複常率均高于LAM組(OR=4.12,95%CI:3.37~5.05,P<0.001;OR=1.60,95%CI:1.31~1.96,P<0.001)。ETV組的ALT複燃率低于LAM組(OR=0.56,95%CI:0.35~0.91,P=0.02)。兩種藥物的不良反應髮生率相噹(OR=1.06,95%CI:0.85~1.31,P=0.61)。結論恩替卡韋可彊效抑製慢性乙型肝炎患者體內的HBV DNA、提高生化學應答、肝組織學改善率,同時具有和其他覈苷痠類藥物一樣的安全性和耐受性。
목적:평개은체잡위(ETV)치료중국만성을형간염환자적료효。방법검색2006년1월지2013년10월소유이ETV위시험조화랍미부정(LAM)위대조조적수궤대조시험(RCT)자료,사열소유문헌적삼고문헌작위보충,량명연구자독립채용Jadad평분대전부납입문헌진행질량평개,이질성분석사용χ2검험,이비치비(OR)위효응량진행Meta분석。결과공유7편RCT문헌납입본연구,기중중문문헌3편,영문문헌4편,연구결과현시,ETV조적HBV DNA저우검측하한적비솔화ALT복상솔균고우LAM조(OR=4.12,95%CI:3.37~5.05,P<0.001;OR=1.60,95%CI:1.31~1.96,P<0.001)。ETV조적ALT복연솔저우LAM조(OR=0.56,95%CI:0.35~0.91,P=0.02)。량충약물적불량반응발생솔상당(OR=1.06,95%CI:0.85~1.31,P=0.61)。결론은체잡위가강효억제만성을형간염환자체내적HBV DNA、제고생화학응답、간조직학개선솔,동시구유화기타핵감산류약물일양적안전성화내수성。
Objective To evaluate the efficacy of entecavir in treatment of patients with chronic hepatitis B in China. Methods Papers from January 2006 to October 2013 were searched, all data were retrieved from randomized controlled trial (RCT). The supplement were from all documents of reference. All patients were divided into two groups: entecavir (ETV) group and lamivudine (LAM) group. Two investigators assessed the quality and extracted the data independently. Heterogeneity was examined by Chi-square test. The effect size for the Meta analysis was evaluated by odds ratio (OR). Results There were seven RCTs were included, among which three references in Chinese and four in English. It showed that negative conversion ratio of HBV DNA and normalization of ALT in ETV group were significantly higher than that in LAM group (OR=4.12, 95%CI:3.37-5.05, P<0.001;OR=1.60, 95%CI:1.31-1.96, P<0.001). The recurrence rate of ALT in ETV group was signiifcantly lower than that in LAM group (OR=0.56, 95%CI:0.35-0.91, P=0.02). There were no signiifcant difference in the adverse effects rates between ETV group and LAM group (OR=1.06, 95%CI:0.85-1.31, P=0.61). Conclusions Entecavir could effectively inhibit HBV DNA and improve the biochemical responses with liver histology period for patients with chronic hepatitis B. The tolerance of ETV are similar to other nucleotide analogues.