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目的评价替比夫定对e抗原阳性慢性乙型肝炎患者的临床疗效。方法收集我院120例经拉米夫定或替比夫定治疗的乙型肝炎E抗原(HBeAg)阳性慢性乙型肝炎患者临床资料,对比拉米夫定和替比夫定患者在4,8,12,24,48周时HBV-DNA水平和HBeAg血清学转换率,且评价治疗期间2组患者不良反应。结果 2组患者在4,8,12周时HBV-DNA水平和HBeAg血清学转换率,组间差异无统计学意义(P>0.05)。与拉米夫定组比较,替比夫定组24,48周时HBV-DNA水平明显较低,HBeAg血清学转换率明显较高(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。替比夫定组40岁以下患者治疗48周时HBeAg血清学转换率为49%,40岁以上患者为9.5%,组间差异有统计学意义(P<0.05)。结论替比夫定治疗40岁以下的HBeAg阳性慢性乙型肝炎患者有较高的HBeAg血清学转换率,且不良反应轻微。
Objective To evaluate the clinical efficacy of telbivudine in e antigen positive chronic hepatitis B patients. Methods The clinical data of 120 patients with hepatitis B E antigen (HBeAg) -positive chronic hepatitis B treated with lamivudine or telbivudine in our hospital were collected. Patients with lamivudine and telbivudine were divided into 4,8 , HBV DNA levels and HBeAg seroconversion rates at 12, 24 and 48 weeks, and adverse reactions were evaluated in both groups during treatment. Results There were no significant differences in HBV-DNA levels and HBeAg seroconversion rates between the two groups at 4, 8 and 12 weeks (P> 0.05). Compared with the lamivudine group, HBV-DNA levels were significantly lower at telbivudine 24 and 48 weeks, and HBeAg seroconversion rate was significantly higher (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). HBeAg seroconversion rate was 49% in telbivudine-treated patients under 40 years of age at 48 weeks, and 9.5% in patients over 40 years of age. The difference was statistically significant (P <0.05). Conclusion Telbivudine has a higher HBeAg seroconversion rate in patients with HBeAg-positive chronic hepatitis B under 40 years of age with minimal adverse reactions.