替比夫定治疗HBeAg阳性慢性乙型肝炎患者40例

目的研究替比夫定治疗e抗原阳性慢性乙型肝炎的近期疗效和安全性。方法80例HBeAg阳性慢性乙型肝炎患者按完全随机对照原则分成试验组和对照组：40例试验组给予替夫比定600mg。1次／d，口服，疗程〉48周；40例对照组，给予阿德福韦酯10mg，1次／d，口服。疗程〉48周。观察治疗第4、8、12、24和48周时两组肝肾功能、血细胞分析、FIBV DNA水平以及HBV血清标志物的变化。结果两组间性别、年龄、体重、血清丙氨酸氨基转移酶（ALT）水平、HBV DNA拷贝数等各项基础资料比较无显著性差异（P〉0．05）。治疗期间两组患者ALT均有显著改善，统计学分析显示无差别。治疗24wk、48wk时试验组患者血清HBV DNA低于检出下限的检出率分别为50％和53．5％，高于对照组的25％和42．5％（P〈0．05）；试验组HBeAg阴转率为30％和42.5％，高于对照组的17．5％和22．5％（P〈0．05）组。治疗48wk后，试验组血清HBV DNA下降了6．4log10拷贝·mL^-2，下降幅度显著大于对照组5.4log10拷贝·mL^-1（P〈0.01）。两组患者均未出现肾功能异常及其它明显不良反应。结论替比夫定治疗HBeAg阳性慢性乙型肝炎疗效好，安全性高。

Telbivudine in treat of 40 patients with HBeAg posive chronic hepatitis

Objective To evaluate the safety and efficaey of telbivudine in treating HBeAg positive chronic hepatitis B. Methods 80 Patients with HBeAg posive chronic hepatitis B according to clinical signs and laboratory tests were randomly divided into trial group （ treated with telbivudine 600mg daily over 48 weeks） or control group （ treated with adefovir 10mg daily over 48 weeks）. The clinical follow up was taken at 4, 8 12, 24, 48 week from the beginning of treatment. Results The basic conditions sex, age, body weight, serum alanine aminotransferase （ALT）, HBV DNA] were matchable between the 2 groups （P〉0.05） before treatment. The rates of normaliziton of serum ALT at week 48 were high （leval more than 70%） in both treatment group, which had no statistically significant difference （P〉0.05）.The propotion of patients in whom serum HBV DNA levels were undetectable by PCR assay was significandy greater in the trial group than the control group at week 24 （50% vs 25%, P〈0.05） and week 48 （53.5% vs 42.5%, P〈0.05）. The rates of HBeAg seroconversion were higher in the trial group than the control group at week 24（ 30%vs 17.5%, P〈0. 05） and week 48 （42.5% vs 22.5%, P〈0.05）. The difference of reduction in serum HBV DNA levels was evident at week 48 （6.4log10 copies per mililiter in trail group and 5.4log10 copies per mililite in eontroll group, P〈0.01 ）. There were no renal function abnormality and other severe adverse reaction in both groups. Conglusion Telbivuding is safe and efficient in treating HBeAg positive hepatitis B.