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恩替卡韦和阿德福韦酯治疗慢性乙型肝炎的疗效比较 预览

Analysis of clinical effect of entecavir and adefovir dipivoxil in treatment of chronic hepatitis B patients
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摘要 目的:分析恩替卡韦(ETV)和阿德福韦酯(ADV)关于医治慢性乙型病毒性肝炎(CHB)的临床应用效果及其差异性。方法:回顾性分析2011年1月至2015年12月在广西医科大学第一附属医院感染性疾病科门诊医治的79例CHB患者的临床资料,根据患者用药情况的不同分为ETV组(n=44)与ADV组(n=35)。观察两组患者用药治疗48周后肝肾功能指标、肌酸激酶(CK)、病毒学及血清学应答情况。结果:ETV组治疗后血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)和碱性磷酸酶(ALP)含量均明显低于治疗前,前白蛋白(PA)含量明显高于治疗前(均P<0.05)。ADV组治疗后血清ALT、AST、GGT含量均明显低于治疗前,CK含量高于治疗前(均P<0.05)。两组治疗后肝功能对比,差异无统计学意义(P>0.05)。治疗后ETV组的HBVDNA转阴率明显高于ADV组(P=0.026)。两组治疗后肾功能指标、病毒学反弹发生率相比无明显差异(P>0.05)。结论:ETV与ADV均可有效治疗CHB,但ETV抗病毒复制效果更为显著,且安全性更高。 Objective: To analyze the clinical efficacy of entecavir (ETV) and adefovir dipivoxil(ADV) in the treatment of chronic hepatitis B (CHB). Methods: A total of 79 patients in our hospital from January 2011 to December 2015 were enrolled in this study,and randomly divided into ETV group ( n =44) and ADV group ( n =35).The liver and renal function indexes,creatine kinase (CK),the virological and serological response were observed after 48 weeks. Results: The serum levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),γ-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) in ETV group were evidently decreased after treatment,while the prealbumin (PA) content was increased ( P <0.05).The levels of serum ALT,AST and GGT after treatment in ADV group were notably decreased,whereas the CK content was increased ( P <0.05).No significant differences were found in the liver function indexes levels ( P >0.05).After treatment,the negative rate of HBV DNA in ETV group was significantly higher than that in ADV group ( P <0.05).There were no significant differences in the renal function and virological rebound rate between the two groups ( P >0.05). Conclusion: Both ETV and ADV were effective for the treatment of CHB,but ETV was superior to ADV in terms of antiviral effect and safety.
作者 彭金林 吴继周 李国坚 吴健林 宁秋悦 席玉梅 李晓晴 覃凤芳 刘瑶 杨春英 Peng Jinlin;Wu Jizhou;Li Guojian;Wu Jianlin;Ning Qiuyue;Xi Yumei;Li Xiaoqing;Qin Fengfang;Liu Yao;Yang Chunying(Department of Infectious Diseases,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处 《广西医科大学学报》 CAS 2019年第5期758-762,共5页 Journal of Guangxi Medical University
基金 国家自然科学基金项目(No.30960170) 广西壮族自治区教育厅重点课题资助项目(No.桂教201202ZD021).
关键词 慢性乙型肝炎 恩替卡韦 阿德福韦酯 临床疗效 chronic hepatitis B entecavir adefovir dipivoxil clinical efficacy
作者简介 通信作者:吴继周,E-mail:wjz925@163.com.
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