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目的探讨不同剂量恩替卡韦治疗慢性乙型肝炎的临床疗效。方法选取2014年3月—2016年3月马龙县人民医院收治的慢性乙型肝炎患者129例,随机将患者分为低剂量组、高剂量组、安慰剂组3组,各43例。低剂量组给予恩替卡韦0.1mg/次口服治疗,高剂量组给予恩替卡韦0.5mg/次口服治疗,安慰剂组给予安慰剂治疗,3组患者均连续治疗4周。比较3组患者乙型肝炎e抗原(HBe Ag)、血清乙型肝炎病毒(HBV)DNA水平、肝功能及不良反应发生情况。结果 3组患者均未出现HBe Ag转阴。治疗前3组患者HBV DNA水平比较,差异无统计学意义(P>0.05);治疗4周低剂量组与高剂量组HBV DNA水平低于治疗前,差异有统计学意义(P<0.05);随访第8周低剂量组与高剂量组HBV DNA水平均有所升高,且高剂量组HBV DNA水平低于低剂量组,差异有统计学意义(P<0.05)。安慰剂组患者治疗前、治疗4周、随访第8周HBV DNA水平比较,差异无统计学意义(P>0.05)。高剂量组ALT复常率高于低剂量组与安慰剂组,差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论恩替卡韦治疗慢性乙型肝炎的临床疗效确切,且与0.1mg/次剂量相比,0.5mg/次剂量恩替卡韦的治疗效果更为理想,抗病毒持久性更强,且不良反应少。
Objective To investigate the clinical efficacy of different doses of entecavir in the treatment of chronic hepatitis B. Methods A total of 129 chronic hepatitis B patients admitted to Marong County People’s Hospital from March 2014 to March 2016 were randomly divided into low dose group, high dose group and placebo group and 43 patients in each group. The low-dose group was given entecavir 0.1mg / time oral treatment, high-dose group entecavir 0.5mg / times oral treatment, placebo group was given placebo treatment, 3 patients were treated for 4 weeks. The levels of hepatitis B e antigen (HBeAg), serum hepatitis B virus (HBV) DNA, liver function and adverse reactions in the three groups were compared. Results None of the three groups showed negative HBeAg. There was no significant difference in HBV DNA levels between the three groups before treatment (P> 0.05). The levels of HBV DNA in the low-dose and high-dose groups for 4 weeks were lower than those before treatment (P <0.05). After 8 weeks of follow-up, the levels of HBV DNA in low-dose group and high-dose group were increased, and the levels of HBV DNA in high-dose group were lower than those in low-dose group (P <0.05). There was no significant difference in HBV DNA levels between the placebo group before treatment, 4 weeks after treatment and 8 weeks after follow-up (P> 0.05). The normalization rate of ALT in high dose group was higher than that in low dose group and placebo group (P <0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P> 0.05). Conclusion The clinical efficacy of entecavir in the treatment of chronic hepatitis B is accurate. Compared with 0.1 mg / dose, entecavir has better therapeutic effect, longer duration of anti-virus and less adverse reactions.