作　　者： (程波）; (普布扎西）; (柏争鸣）; (郭鹏涛）; (大单增）; (王绍奎）;

机构地区： 解放军第四十一医院,西藏山南856100

出　　处： 《西南军医》 2017年第5期409-412,共4页

摘　　要： 目的探讨拉米夫定与恩替卡韦治疗藏族慢性乙型肝炎患者的临床疗效和安全性。方法采用随机数字表法,将符合纳入标准的114例藏族慢性乙型肝炎患者随机分为两组:恩替卡韦组(ETV组,n=57)和拉米夫定(LVD组,n=57)。恩替卡韦组给予恩替卡韦片0.5 mg,口服,1次/d;拉米夫定组给与拉米夫定片100mg,口服,1次/d,两组分别治疗48周。于治疗前及治疗12、24、48周时点测定两组的ALT和HBV DNA值,记录ALT复常、HBV DNA转阴、HBe Ag转阴及血清学转换的患者例数以及治疗过程中不良事件的发生情况。结果与治疗前比较,两组患者治疗12、24、48周时ALT、HBV DNA定量值均下降;与LVD组比较,治疗12、24周时ETV组的ALT、HBV DNA定量值下降,ALT复常率、HBV DNA转阴率升高,差异有统计学意义(P<0.05)。两组患者在治疗过程中均未发生严重不良反应事件。结论拉米夫定与恩替卡韦治疗藏族慢性乙型肝炎患者安全、有效,但拉米夫定耐药性高,恩替卡韦在恢复肝功能及降低HBV复制的效果优于拉米夫定。 Objective To explore the clinical effects of lamivudine and entecavir on Tibetan patients with chronic hepatitis B and the safety. Methods 114 Tibetan patients with chronic hepatitis B were enrolled and randomly divided into 2groups： ETV group and LVD group, 57 in each; oral administration of entecavir, 0. 5 mg, once a day, was applied to patients in ETV group while that of lamivudine, 100 mg, once a day, to patients in LVD group, the courses of the 2groups both lasted fro 48 weeks ; the detection of ALT, HBV-DNA of the patients in both groups was made before treatment and at the time point of the 12 th, 24 th and 48 th week after treatment; ALT normalization, HBV-DNA and HBeAg negative conversion, the case number of seroeonversion and the occurrence of side effects were recorded. Re. sults The levels of ALT and HBV-DNA of the patients in both groups at the time point of the 12 th, 24 th and 48 ,h week after treatment were lower than those before treatment, and ALT normalization rate and HBV-DNA negative conversion rate increased, the difference was of statistical significance （ P 〈 0. 05） ; no side effects occurred in the patients of the 2groups. Conclusions Lamivudine and entecavir are safe and effective on Tibetan patients with chronic hepatitis B; lamivudine is with higher drug resistance and entecavir is superior to lamivudine in recovering hepatic function and de- creasing HBV replication.

关 键 词： 慢性乙型肝炎 恩替卡韦 拉米夫定 疗效