摘要
目的比较恩替卡韦(ETV)、富马酸替诺福韦二吡呋酯(TDF)治疗慢性乙型肝炎及乙型肝炎肝硬化患者的抗病毒效果。方法收集2016年1月~2017年1月在吉林省一汽总医院接受ETV或TDF抗病毒治疗的80例初治慢性乙型肝炎或肝硬化患者,其中接受TDF治疗者38例(TDF组),接受ETV治疗者42例(ETV组)。监测患者治疗前及治疗后第24、36、48周的实验室指标:肝肾功能、血钙、血磷、肌酸激酶、HBV DNA水平、肝炎标志物,以及药物的不良反应。结果治疗第24周时,ETV组患者血清乙型肝炎表面抗原(HBs Ag)明显低于TDF组(P<0.05);治疗第36、48周时,两组HBs Ag比较差异无统计学意义(P>0.05);治疗第24、36、48周时,两组丙氨酸氨基转移酶(ALT)比较差异无统计学意义(P>0.05)。治疗第24、36周时,ETV组HBV DNA水平明显低于TDF组(P<0.05)。治疗第48周时,两组的HBV DNA水平、HBe Ag阳性患者中的HBV DNA水平低于检测值下限比例,乙型肝炎e抗原(HBe Ag)阴转率、HBe Ag阴性患者与HBe Ag阳性患者的ALT复常率比较,差异均无统计学意义(P>0.05)。TDF组有2例患者出现血磷轻度下降,骨密度示轻度骨质疏松。结论在第24周及36周时ETV抑制HBV DNA的能力明显优于TDF,第48周时两组比较无显著差异。
Objective To compare the antiviral effect of Enteeavir （ETV） and Tenofovir Disoproxil Fumarate （TDF） in initial treatment patients with chronic hepatitis B and liver ein＇hosis. Methods A total of 80 initial treatment patients with chronic hepatitis B and liver cirrhosis who received antiviral therapy with TDF or ETV and were regularly followed up in the FAW General Hospital, from January 2016 to January 2017 were enrolled, and 38 patients were treated with TDF （TDF group） and 42 patients were treated with ETV （ETV group）. Laboratory markers were measured before and at 24th, 36th, and 48th week of treatment, including liver and renal function parameters, serum calcium, serum phosphate, ereatine kinase, HBV DNA level, hepatitis markers. Adverse drug reactions were also observed. Results At 24th week of treatment, HBsAg of ETV group was lower than that of TDF group （P 〈 0.05）. At 36th, 48th week of treatment, there was no difference in HBsAg of the two groups （P 〉 0.05）. At 24th, 36th, 48th week of treatment, the two groups had no statistical difference in ALT level （P 〉 0.05）. At 24th, 36th week of treatment, HBV DNA level of ETV group was lower than that of TDF group （P 〈 0.05）. At 48th week of treatment, HBV DNA level, proportion of HBeAg positive patients with HBV DNA level below floor level, rate of HBeAg turning negative, rate of HBeAg negative and positive patients with ALT turning normal in the two groups had no statistically difference （P 〉 0.05）. In TDF group, 2 cases oeeured serum inorganic phosphorus declined slightly, and bone mineral density was detected mild osteoporosi. Conclusion At 24th and 36th week of treatment, ETV restrains HBV DNA better than TDF, while at 48th week there is no differeee between the two drugs.
作者
申恩华
王茉莉
王立红
李欣杉
袁艺萌
陈鹏
袁静
张晶芬
付广双
SHEN Enhua;WANG Moli;WANG Lihong;LI Xinshan;YUAN Yimeng;CHEN Peng;YUAN Jing;ZHANG Jingfen;FU Guangshuang(Department of Infection Disease,the FAW General Hospital,Jilin Province,Changchun 130011,China)
出处
《中国医药导报》
CAS
2018年第28期70-73,共4页
China Medical Herald
基金
吉林省卫生计生科技创新项目(20172C024)
