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目的探讨恩替卡韦(ETV)治疗慢性乙型肝炎临床疗效及安全性。方法将80例慢性乙肝患者按照抽签方法随机均分为对照组与观察组,各为40例。观察组给予0.5mg/d的ETV治疗,对照组给予100mg/d的拉米夫定(LAM)治疗。比较二组治疗前后肝功能指标变化、超声影像学指标变化、治疗后HBV-DNA滴度与转阴率、不良反应。结果①二组治疗前后肝功能指标(ALT、ALB及TBil)相比,差异均具有统计学意义(P<0.05,P<0.01),且二组治疗后上述指标差异也均具有统计学意义(P<0.05);②二组治疗后超声影像学指标相比,差异均具有统计学意义(P<0.05),但二组治疗后超声影像学指标相比,差异均无统计学意义(P均>0.05);③二组治疗前后HBV-DNA滴度相比,差异均具有统计学意义(P<0.05),且二组治疗后HBV-DNA滴度相比,差异也具有统计学意义(P<0.05);观察组治疗后HBV-DNA转阴率为90.00%,显著高于对照组(72.50%)(P<0.05);④二组治疗过程中均未见不良反应发生。结论与LAM相比,ETV治疗慢性乙肝疗效更为显著,安全性高,应在临床上进行推广及应用。
Objective To investigate the clinical efficacy and safety of entecavir (ETV) in the treatment of chronic hepatitis B patients. Methods Eighty patients with chronic hepatitis B were randomly divided into control group and observation group according to random sampling method. The observation group was treated with 0.5 mg / d ETV, while the control group was treated with 100 mg / d lamivudine (LAM). The changes of liver function indexes, ultrasonic imaging changes, HBV-DNA titer and negative conversion rate and adverse reactions after treatment were compared between the two groups. Results ① The liver function indexes (ALT, ALB and TBil) of the two groups before and after treatment were significantly different (P <0.05, P <0.01), and the differences of the above indexes between the two groups were also statistically significant ( (P <0.05); ②The ultrasonic imaging indexes of the two groups after treatment were significantly different (P <0.05), but there was no significant difference between the two groups > 0.05). The difference of HBV-DNA titers between the two groups before and after treatment were statistically significant (P <0.05), and there was significant difference between the two groups in HBV-DNA titers (P <0.05). The negative conversion rate of HBV-DNA in the observation group after treatment was 90.00%, which was significantly higher than that in the control group (72.50%) (P <0.05). No adverse reactions occurred in the two groups during the course of treatment. Conclusion Compared with LAM, ETV treatment of chronic hepatitis B more significant effect, high safety, should be clinically promoted and applied.