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目的:观察替比夫定治疗慢性乙型肝炎(CHB)的疗效与安全性。方法:216例患者被随机分为治疗组与对照组,两组基础治疗相同,治疗组同时口服替比夫定600mg,qd,疗程1年,观察两组患者血清丙氨酸转氨酶(ALT),HBeAg/HBeAb和HBV DNA转换及临床疗效,治疗组治疗前、治疗结束时分别进行肝组织活检,作病理检查。结果:治疗结束时治疗组和对照组ALT复常率为78.6%与73.1%(P>0,05),HBV DNA阴转率为71.4%与5.8%(P<0.01),HBeAg/HBeAb血清转换率为26.8%与3.8%(P<0.01);CHB轻、中、重度HBV DNA阴转率为50%,80.8%与78.6%(轻度与中、重度P<0.01),HBeAg/HBeAb血清转换率为9.4%,32.7%与35.7%(轻度与中、重度P<0.01);不良反应少见,76.8%的患者肝组织炎症明显减轻。结论:替比夫定可快速、高效抑制HBV DNA复制,明显减轻肝组织的炎症,治疗CHB安全有效。
Objective: To observe the efficacy and safety of telbivudine in the treatment of chronic hepatitis B (CHB). Methods: Two hundred and sixty-six patients were randomly divided into treatment group and control group. The two groups had the same basic treatment. The treatment group also received telbivudine 600 mg qd for 1 year. The serum levels of alanine aminotransferase (ALT) HBeAg / HBeAb and HBV DNA conversion and clinical efficacy, the treatment group before treatment, liver biopsy were performed at the end of treatment for pathological examination. Results: At the end of treatment, the ALT abnormalities were 78.6% and 73.1% (P> 0.05) in the treatment and control groups, respectively. The negative conversion rates of HBV DNA were 71.4% and 5.8% (P <0.01), and the HBeAg / HBeAb seroconversion (P <0.01). The negative conversion rates of mild, moderate, and severe HBV DNA in CHB were 50%, 80.8% and 78.6% (mild and moderate, severe, P <0.01), and HBeAg / HBeAb seroconversion Rates were 9.4%, 32.7% and 35.7% (mild and moderate, severe, P <0.01). Adverse reactions were rare, and hepatic inflammation was significantly reduced in 76.8% of patients. Conclusion: Telbivudine can inhibit the HBV DNA replication rapidly and efficiently, reduce the inflammation of liver tissue and treat CHB safely and effectively.