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目的评价恩替卡韦(ETV)和替比夫定(LdT)初始治疗慢性乙型肝炎(CHB)的疗效及安全性。方法 118例CHB患者分别采用ETV(ETV组,60例)和LdT(LdT组,58例)治疗48周,检测治疗前和治疗第12、24、36、48、72和96周的HBV DNA阴转率、ALT复常率和HBeAg转换率等相关指标。结果治疗第12、24和36周时,ETV组的HBV DNA阴转率分别为81.7%、83.3%和86.7%,高于LdT组的53.4%、58.6%和62.1%(P<0.05)。两组患者治疗过程中ALT复常率相仿(P>0.05)。治疗第24、36和48周时,ETV组的HBeAg转换率分别为6.3%、12.5%和18.8%,低于LdT组28.6%、39.3%和50.0%(P<0.05)。两组治疗期间未发现明显不良反应。结论ETV治疗CHB患者较LdT能更快、更强抑制HBV复制。LdT治疗具有更高的血清学转换率。
Objective To evaluate the efficacy and safety of entecavir (ETV) and telbivudine (LdT) in the initial treatment of chronic hepatitis B (CHB). Methods A total of 118 CHB patients were treated with ETV (ETV group, 60 cases) and LdT (LdT group, 58 cases) for 48 weeks respectively. HBV DNA levels before and 12, 24, 36, 48, 72 and 96 weeks Transfer rate, ALT normalization rate and HBeAg conversion rate and other related indicators. Results At the 12th, 24th and 36th week, the HBV DNA negative rates in ETV group were 81.7%, 83.3% and 86.7% respectively, which were higher than those in LdT group (53.4%, 58.6% and 62.1%, P <0.05). ALT normalization rate was similar between the two groups during treatment (P> 0.05). At 24, 36 and 48 weeks of treatment, HBeAg conversion rates in ETV group were 6.3%, 12.5% and 18.8%, respectively, lower than those in LdT group (28.6%, 39.3% and 50.0%, P <0.05). No significant adverse reactions were found during the two groups. Conclusion ETV treatment of CHB patients than LdT faster and stronger inhibition of HBV replication. LdT treatment has a higher seroconversion rate.