【摘要】 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。更多还原

【Abstract】 Objective:To observe the efficacy and safety of telbivudine in the treatment of patients with chronic hepatitis B.Methods:Patients with chronic hepatitis B(n=216)were randomly divided into two groups.The patients were treated with basic treatments(control);or with oral telbivudine(600 mg,qd)for one year in addition of the same basic treatments.The levels of serum ALT and HBV DNA were detected in all the patients before and after the treatments.In addition,the conversion of HBeAg into HBeAb and the clinical effects were observed.For pathological examination,the liver tissues from patients in telbivudine group were taken by needle biopsy before and after the treatments,and in the follow-up period.Results:The recovery rate of serum ALT was 78.6% and 73.1% in telbivudine and control groups(P>0.05).Serum HBV DNA was converted from positive to negative in some patients after the treatments,which was significantly higher(71.4% vs 5.8%,P<0.01)in telbivudine group than in control group.The conversion rate of HBeAg to HBeAb was also higher(26.8% vs 3.8%,P<0.01)in telbivudine group.In mild,moderate and severe patients,HBV DNA conversion rates were 50%,80.8% and 78.6,and HBeAg/HBeAb conversion rates were 9.4%,32.7% and 35.7%.Few adverse reactions were observed overall the treatment duration.The inflammation in liver tissues was significantly attenuated in 76.8% patients.Conclusion:Telbivudine can rapidly and effectively inhibit the replication of HBV DNA,and attenuate the liver tissue inflammation;the drug is safe as well.[更多还原