摘要
目的:研究阿德福韦酯治疗失败慢性乙型肝炎(CHB)患者应用替诺福韦酯与恩替卡韦单药序贯治疗的临床效果。方法:选取2014年1月-2019年1月本院服用阿德福韦酯治疗失败的100例CHB患者。根据随机数字表法分为对照组和观察组,各50例。在护肝治疗基础上,对照组给予恩替卡韦序贯治疗,观察组给予替诺福韦酯序贯治疗。观察比较两组患者治疗前和治疗12、24、48周后的HBV-DNA转阴率、肝肾功能变化,及治疗48周后的临床疗效和不良反应发生情况。结果:治疗期间,两组的ALT、AST水平均呈明显下降趋势(P<0.05);两组的Scr水平均呈上升趋势,但组间比较,差异均无统计学意义(P>0.05)。治疗前,两组的ALT、AST和Scr水平比较,差异均无统计学意义(P>0.05)。治疗48周后,观察组的ALT水平显著低于对照组(P<0.05);治疗24、48周后,观察组的AST水平均显著低于对照组(P<0.05);治疗12、24、48周后,两组的Scr水平比较,差异均无统计学意义(P>0.05)。治疗12、24、48周后,两组的HBV-DNA转阴率比较,差异均无统计学意义(P>0.05)。两组的临床总有效率和不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:替诺福韦酯与恩替卡韦单药序贯治疗均能够有效抑制阿德福韦酯治疗失败CHB患者的HBV病毒复制,改善肝功能,其中替诺福韦酯对于患者的肝功能恢复较快,故对于恩替卡韦治疗效果欠佳的患者,可选择替诺福韦酯作为补救治疗方案。
Objective:To study the clinical effect of Tenofovir Dipivoxil and Entecavir single drug sequential therapy in the treatment of chronic hepatitis B (CHB) patients with failure of Adefovir Dipivoxil.Method:A total of 100 CHB patients who failed Adefovir Dipivoxil therapy in our hospital from January 2014 to January 2019 were selected.According to the random number table method,the patients were divided into control group and observation group,50 cases in each group.On the basis of liver protection treatment,the control group was given Entecavir sequential treatment,and the observation group was given Tenofovir Dipivoxil sequential treatment.The HBV-DNA negative conversion rate,liver and kidney function changes before treatment and after 12,24 and 48 weeks of treatment were observed and compared,as well as the clinical efficacy and adverse reactions after 48 weeks of treatment.Result:During the treatment,the levels of ALT and AST in both groups showed a significant downward trend (P<0.05).Scr levels in both groups showed an upward trend,but there were no statistically significant differences between the two groups (P>0.05).Before treatment,ALT,AST and Scr levels were compared between the two groups,the differences were not statistically significant (P>0.05).After 48 weeks of treatment,ALT level in the observation group was significantly lower than that in the control group (P<0.05).After 24 and 48 weeks of treatment,AST levels in the observation group were significantly lower than those in the control group (P<0.05).After 12,24,and 48 weeks of treatment,there were no significant differences in Scr between the two groups (P>0.05).After 12,24,and 48 weeks of treatment,there were no significant differences in HBV-DNA negative conversion rate between the two groups (P>0.05).There were no statistically significant differences between the two groups in total clinical response rate and incidence of adverse reactions (P>0.05).Conclusion:Both Tenofovir Dipivoxil and Entecavir single drug sequential therapy can effectively inhibit HBV replication and improve liver function in CHB patients who failed to receive Adefovir Dipivoxil.Among them,Tenofovir Dipivoxil has a faster recovery of liver function.Therefore,Tenofovir Dipivoxil can be selected as the remedial treatment for patients with poor efficacy of Entecavir.
作者
韩思源
全冰
HAN Siyuan;QUAN Bing(Songshan Lake Central Hospital of Dongguan City,Dongguan 523326,China)
出处
《中国医学创新》
CAS
2020年第27期11-14,共4页
Medical Innovation of China
关键词
替诺福韦酯
恩替卡韦
单药序贯
阿德福韦酯治疗失败
慢性乙型肝炎
Tenofovir Dipivoxil
Entecavir
Single drug sequential
Adefovir Dipivoxil treatment failure
Chronic hepatitis B
