中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
12期
1768-1772
,共5页
韩璐%吴岩%俞晓艳%原永芳
韓璐%吳巖%俞曉豔%原永芳
한로%오암%유효염%원영방
慢性乙型肝炎%恩替卡韦%阿德福韦酯%Meta分析
慢性乙型肝炎%恩替卡韋%阿德福韋酯%Meta分析
만성을형간염%은체잡위%아덕복위지%Meta분석
Chronic hepatitis B%Entecavir%Adefovir%Meta-analysis
目的 比较恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的疗效.方法 使用英文检索词entecavir、adefovir、randomized controlled trial、chronichepatitis B;中文检索词恩替卡韦、阿德福韦酯、随机对照、慢性乙型肝炎,检索2013年12月1日以前Cochrane library、Pubmed、EMBASE、中国科技期刊数据库(维普)、中国期刊全文数据库(CNKI)、万方数字化期刊全文库中的恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的随机对照研究文献,用Review Manager 5.1软件通过Meta分析法比较二者的疗效.结果 共5项随机对照研究符合纳入标准.Meta分析结果显示,恩替卡韦在丙氨酸转氨酶(ALT)复常率[相对危险度(RR)=1.15,95%置信区间(CI):1.03 ~ 1.29,P=0.01]、乙型肝炎病毒脱氧核糖核酸(HBV DNA)低于检测下限比例(RR=2.12,95% CI:1.69 ~ 2.65)方面优于阿德福韦酯,差异有统计学意义(P<0.01);而2组乙型肝炎e抗原(HBeAg)转阴率(RR=1.01,95% CI:0.67 ~ 1.52,P=0.98)、HBeAg血清转换率(RR=1.70,95% CI:0.91~3.17,P=0.10)的差异无统计学意义.结论 恩替卡韦在促使患者ALT回复正常水平和降低血清HBV DNA载量方面优于阿德福韦酯,但在HBeAg转阴率、HBeAg血清转换率方面二者相似.
目的 比較恩替卡韋和阿德福韋酯治療慢性乙型肝炎的療效.方法 使用英文檢索詞entecavir、adefovir、randomized controlled trial、chronichepatitis B;中文檢索詞恩替卡韋、阿德福韋酯、隨機對照、慢性乙型肝炎,檢索2013年12月1日以前Cochrane library、Pubmed、EMBASE、中國科技期刊數據庫(維普)、中國期刊全文數據庫(CNKI)、萬方數字化期刊全文庫中的恩替卡韋和阿德福韋酯治療慢性乙型肝炎的隨機對照研究文獻,用Review Manager 5.1軟件通過Meta分析法比較二者的療效.結果 共5項隨機對照研究符閤納入標準.Meta分析結果顯示,恩替卡韋在丙氨痠轉氨酶(ALT)複常率[相對危險度(RR)=1.15,95%置信區間(CI):1.03 ~ 1.29,P=0.01]、乙型肝炎病毒脫氧覈糖覈痠(HBV DNA)低于檢測下限比例(RR=2.12,95% CI:1.69 ~ 2.65)方麵優于阿德福韋酯,差異有統計學意義(P<0.01);而2組乙型肝炎e抗原(HBeAg)轉陰率(RR=1.01,95% CI:0.67 ~ 1.52,P=0.98)、HBeAg血清轉換率(RR=1.70,95% CI:0.91~3.17,P=0.10)的差異無統計學意義.結論 恩替卡韋在促使患者ALT迴複正常水平和降低血清HBV DNA載量方麵優于阿德福韋酯,但在HBeAg轉陰率、HBeAg血清轉換率方麵二者相似.
목적 비교은체잡위화아덕복위지치료만성을형간염적료효.방법 사용영문검색사entecavir、adefovir、randomized controlled trial、chronichepatitis B;중문검색사은체잡위、아덕복위지、수궤대조、만성을형간염,검색2013년12월1일이전Cochrane library、Pubmed、EMBASE、중국과기기간수거고(유보)、중국기간전문수거고(CNKI)、만방수자화기간전문고중적은체잡위화아덕복위지치료만성을형간염적수궤대조연구문헌,용Review Manager 5.1연건통과Meta분석법비교이자적료효.결과 공5항수궤대조연구부합납입표준.Meta분석결과현시,은체잡위재병안산전안매(ALT)복상솔[상대위험도(RR)=1.15,95%치신구간(CI):1.03 ~ 1.29,P=0.01]、을형간염병독탈양핵당핵산(HBV DNA)저우검측하한비례(RR=2.12,95% CI:1.69 ~ 2.65)방면우우아덕복위지,차이유통계학의의(P<0.01);이2조을형간염e항원(HBeAg)전음솔(RR=1.01,95% CI:0.67 ~ 1.52,P=0.98)、HBeAg혈청전환솔(RR=1.70,95% CI:0.91~3.17,P=0.10)적차이무통계학의의.결론 은체잡위재촉사환자ALT회복정상수평화강저혈청HBV DNA재량방면우우아덕복위지,단재HBeAg전음솔、HBeAg혈청전환솔방면이자상사.
Objective To evaluate the effect of entecavir and adefovir in the treatment of patients with chronic hepatitis B.Methods Correspondent data were retrieved from database ochrane library,Pubmed,EMBASE,Chinese scientific journals database (VIP),CNKI database,Wanfang database before December 1,2013 using the key words entecavir、adefovir、randomized controlled trial 、chronic hepatitis B to collect clinical randomized controlled trials.Statistical analysis was performed by Meta-analysis using Review Manager 5.1.Results Five randomized controlled trials met the inclusion and exclusion criteria.Meta-analysis showed that patients in entecavir group had higher rates of ALT normalization(RR =1.15,95% CI:1.03-1.29,P =0.01),lowering HBV DNA to undetectable levels (RR =2.12,95% CI:1.69-2.65,P < 0.01).The loss of HBeAg (RR =1.01,95 % CI:0.67-1.52,P =0.98) and HBeAg seroconversion (RR =1.70,95 % CI:0.91-3.17,P =0.10) had no statistical significanc.Conclusion Based on our Meta analysis results,the entecavir is superior to adefovir dipivoxil in decreasing serum HBV DNA and normalizing seruna ALT;however,as for the loss of HBeAg and HBeAg sero-conversion,the efficacies of the two drugs are similar.