恩替卡韦治疗HBeAg阳性乙型肝炎临床观察

目的：探讨恩替卡韦治疗HBeAg阳性乙型肝炎的疗效与安全性。方法：140例慢性乙肝患者随机分为2组：观察组予恩替卡韦0．5mg／d，对照组予拉米夫定100mg／d，疗程均为48周。观察两组HBVDNA阴转率、ALT复常率、HbeAg血清转换率以及不良反应发生情况。结果：在治疗12周后，观察组与对照组HBVDNA阴转率分别为47．1％、22．9％（P〈0．01），ALT复常率分别为51．4％、31．4％（P〈0．05），在治疗48周后，观察组与对照组HBVDNA阴转率分别为88．6％、48．6％（P〈0．01），ALT复常率分别为90．0％、72．9％（P〈0．01）。HbeAg血清转换率无统计学差异，两组患者未见严重不良反应。结论：恩替卡韦治疗HBeAg阳性乙肝患者，较拉米夫定起效快、作用强，且安全性好。

Clinical Observation of Entecavir in Treatment of HBeAg Positive Patients with Hepatitis B

Objective： To investigate efficacy and safety of entecavir on treatment of hepatitis B with positive HBeAg. Methods： 140 patients with chronic hepatitis B were randomly divided into 2 groups： study group were treated with entecavir 0.5 mg/d, and the control group were given lamivudine 100 mg/d. Both of the course was 48 weeks. HBV DNA negative conversion rates, ALT normalization rate, HBeAg seroconversion rates and incidence of adverse reactions were observed. Results： After 12 weeks of treatment, HBV DNA negative conversion rate of the observation and control group were 47.1% and 22.9% （P 〈0.01）, respectively. ALT normalization rate were 51,4% and 31.4% （P 〈0.05）, respectively. After 48 weeks of treatment, HBV DNA negative conversion rate of the observation and control group were 88.6% and 48.6% （P 〈0.01）, respectively. ALT normalization rate were 90.0% and 72.9% （P 〈0.01）, respectively. HBeAg seroconversion between the two groups were no significant difference. No serious adverse events occurred in the both groups. Conclusion： Compared with lamivudine, entecavir shows more rapid onset, stronger efficacy, and safety on treatment of hepatitis B with positive HBeAg.