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目的比较恩替卡韦(ETV)与阿德福韦酯(ADV)治疗慢性乙型肝炎的近期疗效和不良反应。方法将2007年6月至2008年5月安徽医科大学第一附属医院感染病科收治的99例慢性乙型肝炎患者,随机分为治疗组和对照组,观察治疗中DNA定量等指标变化。结果比较两组治疗后24、48、96周HBVDNA阴性率,差异有统计学意义(P<0.05)。与治疗起始相比,治疗组24、48周HBVDNA下降幅度均比对照组大,差异有统计学意义(P<0.05)。试验中治疗组未发现病毒学反弹,对照组出现1例;两组HBVDNA载量500～999copies/mL,300～499copies/mL和<300copies/mL者差异无统计学意义。两组HBeAg(+)患者HBVDNA阴性率差异有统计学意义(P<0.05);试验中未发现HBeAg转换。结论 ETV治疗慢性乙型肝炎早期抗病毒活性明显优于ADV,未见明显不良反应。
Objective To compare the short-term effects and side effects of entecavir (ETV) and adefovir dipivoxil (ADV) in the treatment of chronic hepatitis B patients. Methods From June 2007 to May 2008, 99 patients with chronic hepatitis B admitted to Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University were randomly divided into treatment group and control group, and the changes of DNA quantification and other indexes were observed. Results The negative rates of HBVDNA at 24, 48 and 96 weeks after treatment were statistically significant (P <0.05). Compared with the initial treatment, the decrease of HBVDNA in treatment group at 24 and 48 weeks was larger than that in control group (P <0.05). There was no virological rebound in the treatment group and 1 case in the control group. There was no significant difference in HBVDNA loading between 500 ~ 999copies / mL, 300 ~ 499copies / mL and <300copies / mL in two groups. The negative rates of HBVDNA in two groups of HBeAg (+) patients were statistically significant (P <0.05); no HBeAg conversion was found in the trial. Conclusion The early antiviral activity of ETV in the treatment of chronic hepatitis B is better than that of ADV, and no obvious adverse reaction is found.