中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
17期
116-119
,共4页
恩替卡韦%拉米夫定%慢性乙肝%疗效%安全性
恩替卡韋%拉米伕定%慢性乙肝%療效%安全性
은체잡위%랍미부정%만성을간%료효%안전성
Entecavir%Lamivudine%Chronic hepatitis B%Efficacy%Safety
目的：探讨恩替卡韦(ETV)与拉米夫定(LAM)初次治疗慢性乙型肝炎(CHB)的效果和安全性。方法选择2012年7月~2013年6月在本院确诊为CHB的患者，共212例，将其随机分为ETV组(n=102，4例中途退出)和LAM组(n=105，1例中途退出)。ETV组患者口服ETV，0.5 mg/d，LAM组患者口服LAM，100 mg/d，疗程均为48周。比较治疗期间两种药物对HBV DNA载量、ALT复常和HBeAg转阴的作用及其不良反应情况。结果治疗48周后，ETV组患者的HBV DNA转阴率(82.4%vs 44.8%)和ALT复常率(86.3% vs 73.3%)均高于LAM组(P<0.05)。ETV组患者的病毒学突破率(1.0%vs 17.1%)和耐药突变率(0% vs 15.2%)均低于LAM组(P<0.01)。两组患者的HBeAg转阴率、HBeAg/HBeAb血清学转换率和不良反应的发生率差异无统计学意义(P>0.05)。结论与LAM相比，ETV能更有效地抑制HBV DNA复制，减少耐药发生率，且安全性与LAM相当，是初次治疗CHB的选择。
目的：探討恩替卡韋(ETV)與拉米伕定(LAM)初次治療慢性乙型肝炎(CHB)的效果和安全性。方法選擇2012年7月~2013年6月在本院確診為CHB的患者，共212例，將其隨機分為ETV組(n=102，4例中途退齣)和LAM組(n=105，1例中途退齣)。ETV組患者口服ETV，0.5 mg/d，LAM組患者口服LAM，100 mg/d，療程均為48週。比較治療期間兩種藥物對HBV DNA載量、ALT複常和HBeAg轉陰的作用及其不良反應情況。結果治療48週後，ETV組患者的HBV DNA轉陰率(82.4%vs 44.8%)和ALT複常率(86.3% vs 73.3%)均高于LAM組(P<0.05)。ETV組患者的病毒學突破率(1.0%vs 17.1%)和耐藥突變率(0% vs 15.2%)均低于LAM組(P<0.01)。兩組患者的HBeAg轉陰率、HBeAg/HBeAb血清學轉換率和不良反應的髮生率差異無統計學意義(P>0.05)。結論與LAM相比，ETV能更有效地抑製HBV DNA複製，減少耐藥髮生率，且安全性與LAM相噹，是初次治療CHB的選擇。
목적：탐토은체잡위(ETV)여랍미부정(LAM)초차치료만성을형간염(CHB)적효과화안전성。방법선택2012년7월~2013년6월재본원학진위CHB적환자，공212례，장기수궤분위ETV조(n=102，4례중도퇴출)화LAM조(n=105，1례중도퇴출)。ETV조환자구복ETV，0.5 mg/d，LAM조환자구복LAM，100 mg/d，료정균위48주。비교치료기간량충약물대HBV DNA재량、ALT복상화HBeAg전음적작용급기불량반응정황。결과치료48주후，ETV조환자적HBV DNA전음솔(82.4%vs 44.8%)화ALT복상솔(86.3% vs 73.3%)균고우LAM조(P<0.05)。ETV조환자적병독학돌파솔(1.0%vs 17.1%)화내약돌변솔(0% vs 15.2%)균저우LAM조(P<0.01)。량조환자적HBeAg전음솔、HBeAg/HBeAb혈청학전환솔화불량반응적발생솔차이무통계학의의(P>0.05)。결론여LAM상비，ETV능경유효지억제HBV DNA복제，감소내약발생솔，차안전성여LAM상당，시초차치료CHB적선택。
Objective To investigate effect and safety of entecavir (ETV) and lamivudine (LAM) in initial treatment of chronic hepatitis B(CHB). Methods 122 patients with CHB in our hospital from July 2012 to 2013 June were selected, and were randomly divided into ETV group (n=102,4 cases were dropped out) and LAM group (n=105,1 case was dropped out).ETV group was reated with ETV,0.5 mg/d,LAM group was reated with LAM,100 mg/d,course of treatment was 48 weeks.Effect of two drugs on HBV DNA load, ALT normalization,HBeAg negative and adverse effects was com-pared during treatment period. Results After treatment 48 weeks,HBV DNA conversion negative rate (82.4% vs 44.8%) and ALT recovery rate (86.3% vs 73.3%) in ETV group was higher than that of LAM group (P<0.05).Virologic break-through rate (1.0% v s 17.1%) and drug resistance mutation rate (0% v s 15.2%) in ETV group was lower than that of LAM group(P<0.01).There was no statistical difference of HBeAg negative rate,HBeAg/HBeAb seroconversion rate,inci-dence of adverse reaction between two groups (P>0.05). Conclusion Compared with LAM,ETV can effectively inhibit HBV DNA replication and reduce drug resistance rate,the safety of ETV is equivalent to LAM,ETV is the first choice for the treatment of CHB.
