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目的观察应用个体化抗病毒路线图治疗HBeAg阳性慢性乙型肝炎的疗效及药品性价比。寻找符合国情的疗效好,价格便宜的治疗方案。方法在患者知情同意的情况下,选择符合条件的患者66例分为个体化组(36例)和对照组(30例)。个体化组依据路线图进行治疗,对照组初始干扰素联合恩替卡韦治疗。治疗24、48、72周及停药24周时进行生物化学、病毒学、血清学评估,应答疗效比较采用χ2检验。结果治疗24周,个体化组和对照组的HBsAg低于检测下限的比率,HBeAg低于检测下限的比率,HBV DNA低于检测下限的比率分别为11.1%,27.8%,38.9%和16.7%,40.8%,96.7%。对照组好于个体化组,但继续治疗至72周时,个体化组与对照组的HBsAg、HBeAg、HBV DNA低于检测下限的比率分别为30.6%、69.4%、97.2%和20%、43.3%、93.3%。两组比较HBeAg差异有统计学意义(P<0.05),个体化组人均药品费用[(20000±5000)元]低于对照组[(30000±5000)元]。结论应用个体化路线图方案来治疗HBeAg阳性的慢性乙型肝炎患者不仅提高HBsAg、HBeAg低于检测下限的比率,还可为患者节省药品费用。
Objective To observe the curative effect and drug cost-effectiveness of HBsAg-positive chronic hepatitis B using individualized antiviral route map. Find a curative effect in line with the national conditions, the price of cheap treatment options. Methods Sixty-six patients who were eligible were divided into individualized group (36 cases) and control group (30 cases) with informed consent of patients. The individualized group was treated according to the roadmap, while the control group was treated with initial interferon plus entecavir. Biochemical, virological, and serological evaluation were performed 24, 48 and 72 weeks after treatment and 24 weeks after discontinuation. Chi-square test was used to compare the response efficacy. Results At 24 weeks of treatment, the rates of HBsAg below the limit of detection, HBeAg below the limit of detection and HBV DNA below the limit of detection were 11.1%, 27.8%, 38.9% and 16.7% respectively in the individualized and control groups, 40.8%, 96.7%. The control group was better than the individual group, but the ratio of HBsAg, HBeAg and HBV DNA below the detection limit of the individualized group and the control group was 30.6%, 69.4%, 97.2% and 20%, 43.3 %, 93.3%. The differences of HBeAg between the two groups were statistically significant (P <0.05). The per capita cost of medicine [(20000 ± 5000) yuan in the individualized group was lower than that of the control group [(30000 ± 5000) yuan]. Conclusion The application of individualized route plans to treat patients with HBeAg-positive chronic hepatitis B not only improves the ratio of HBsAg and HBeAg below the detection limit, but also saves patients the cost of medicines.